Schizophrenia Treatment Options

 

HOW IS IT TREATED?

The good news about schizophrenia is that although there is no cure, it can be treated effectively with prescription medications. In the past decade, several new antipsychotic medications ("atypical antipsychotics") have been developed that have fewer side effects than older medications ("typical antipsychotics").

Medication therapies as well as numerous psychological rehabilitation programs are the mainstays of treatment. To learn more about non-drug therapies, click on the "Helping Yourself" button at the top of this page. Goals of therapy are to reduce schizophrenic symptoms, prevent return of symptoms, minimize side effects from medications, and help the individual function more normally in society.
 

Initial drug treatment should include use of one of the atypical antipsychotic medications--such as olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal), or aripiprazole (Abilify). If no response is seen within 3 to 4 weeks, then addition of a second atypical antipsychotic is warranted. If no response is evident while on two atypical antipsychotics, then addition of a third atypical can be tried. If schizophrenic symptoms are still present after trying three atypical antipsychotics, a typical antipsychotic medication--for instance, chlorpromazine, fluphenazine, and haloperidol--should be initiated. Clozapine (Clozaril), an atypical antipsychotic, is usually left as a last-line therapy because of its potential for serious side effects. In most medication-resistant patients, however, clozapine can be used with mood stabilizers (such as lithium), antidepressants, other atypical antipsychotics, typical antipsychotics, or electroconvulsive therapy (ECT). If noncompliance with a medication regimen is suspected, some typical antipsychotics are available in long-acting, injectable forms--for example, haloperidol decanoate or fluphenazine decanoate.
 

After treating the first psychotic episode, most schizophrenic patients should continue treatment for at least 1 year. If the individual has multiple psychotic episodes, then treatment should last for at least 5 years. Patients with schizophrenia should be evaluated at least annually to determine the need to continue medication. Continuing antipsychotic medications indefinitely should be considered for patients with a history of serious suicide attempts or violent, aggressive behavior.