How can schizophrenia be managed

Some people find expressing things in a non-verbal way through the arts can provide a new experience of schizophrenia and help them develop new ways of relating to others.

Arts therapies have been shown to alleviate the negative symptoms of schizophrenia in some people. The National Institute for Health and Care Excellence NICE recommends that arts therapies are provided by an arts therapist registered with the Health and Care Professions Council who has experience of working with people with schizophrenia. Page last reviewed: 11 November Next review due: 11 November Treatment - Schizophrenia.

Most people with schizophrenia are treated by community mental health teams CMHTs. A CMHT can be made up of and provide access to: social workers community mental health nurses — who have specialist training in mental health conditions occupational therapists pharmacists counsellors and psychotherapists psychologists and psychiatrists — the psychiatrist is usually the senior clinician in the team After your first episode of schizophrenia, you should initially be referred to an early intervention team.

Care programme approach CPA People with complex mental health conditions are usually entered into a treatment process known as a care programme approach CPA. There are 4 stages to a CPA: assessment — your health and social needs are assessed care plan — a care plan is created to meet your health and social needs key worker appointed — a key worker, usually a social worker or nurse, is your first point of contact with other members of the CMHT reviews — your treatment will be regularly reviewed and, if needed, changes to the care plan can be agreed Not everyone uses the CPA.

Further information Rethink Mental Illness: Care programme approach Acute episodes People who have serious psychotic symptoms as the result of an acute schizophrenic episode may require a more intensive level of care than a CMHT can provide.

These episodes are usually dealt with by antipsychotic medication and special care. Without the involvement of the CRT, these people would require treatment in hospital. Voluntary and compulsory detention More serious acute schizophrenic episodes may require admission to a psychiatric ward at a hospital or clinic. It's only possible for someone to be compulsorily detained at a hospital if they have a severe mental disorder and if detention is necessary: in the interests of the person's own health and safety to protect others People with schizophrenia who are compulsorily detained may need to be kept in locked wards.

Advance statements If it's felt there's a significant risk of future acute schizophrenic episodes occurring, you may want to write an advance statement. If you want to make an advance statement, talk to your care co-ordinator, psychiatrist or GP. Further information Mind: Health and social care rights Antipsychotics Antipsychotics are usually recommended as the initial treatment for the symptoms of an acute schizophrenic episode.

You may only need antipsychotics until your acute schizophrenic episode has passed. There are 2 main types of antipsychotics: typical antipsychotics — the first generation of antipsychotics developed in the s atypical antipsychotics — newer-generation antipsychotics developed in the s The choice of antipsychotic should be made following a discussion between you and your psychiatrist about the likely benefits and side effects.

The side effects of typical antipsychotics include: shaking trembling muscle twitches muscle spasms Side effects of both typical and atypical antipsychotics include: drowsiness weight gain, particularly with some atypical antipsychotics blurred vision constipation lack of sex drive dry mouth Tell your care co-ordinator, psychiatrist or GP if your side effects become severe. Your medicine should be reviewed at least once a year.

Further information Mind: Antipsychotics Royal College of Psychiatrists: Depot medication Psychological treatment Psychological treatment can help people with schizophrenia cope with the symptoms of hallucinations or delusions better.

Roluperidone MIN Roluperidone is a cyclic amide derivative developed to target the negative symptoms of and cognitive dysfunction in schizophrenia. Address correspondence to: mmaroney pharmacy. About schizophrenia. Schizophrenia and Related Disorders Alliance of America website. Accessed December 26, Nat Rev Dis Primers. Practice guideline for the treatment of patients with schizophrenia, second edition.

Am J Psychiatry. Keeping up with the therapeutic advances in schizophrenia: a review of novel and emerging pharmacological entities. CNS Spectr. Guideline watch September : practice guideline for the treatment of patients with schizophrenia.

American Psychiatric Association website. Published September Accessed Feburary 7, Effectiveness of antipsychotic drugs in patients with chronic schizophrenia [published correction appears in N Engl J Med. N Engl J Med. Effectiveness of antipsychotics in first-episode schizophrenia and schizophreniform disorder on response and remission: an open randomized clinical trial EUFEST. Schizophr Res.

Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis. Accessed February 14, Clinical guidance on the identification and management of treatment-resistant schizophrenia. J Clin Psychiatry. Relapse prevention in schizophrenia with new-generation antipsychotics: a systematic review and exploratory meta-analysis of randomized, controlled trials. Schizophrenia: overview and treatment options. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis [published correction appears in Lancet.

Remington G. Tardive dyskinesia: eliminated, forgotten, or overshadowed? Curr Opin Psychiatry. Treatment of tardive dyskinesia with VMAT-2 inhibitors: a systematic review and meta-analysis of randomized controlled trials. Drug Des Devel Ther. Consensus development conference on antipsychotic drugs and obesity and diabetes. Diabetes Care. Metformin for weight loss and metabolic control in overweight outpatients with schizophrenia and schizoaffective disorder.

Antipsychotic-induced hyperprolactinemia: synthesis of world-wide guidelines and integrated recommendations for assessment, management and future research.

Psychopharmacology Berl. Fellner C. New schizophrenia treatments address unmet clinical needs. FDA approves Secuado asenapine transdermal system, the first-and-only transdermal patch for the treatment of adults with schizophrenia [news release]. Accessed February 25, Secuado [prescribing information]. If you find you have problems with thinking, there are programs that can help. Cognitive remediation programs can help you improve your attention, memory and organisation skills.

There are also programs that help you work on the way you interact with other people. Psychoeducation helps people with schizophrenia and their partner or family understand the illness. Psychoeducation programs explain about symptoms, treatment options, recovery, and services that can help. You can have psychoeducation individually or in groups. It can include written information, videos, websites, meetings, or discussions with your case manager or psychiatrist.

Your family can help you understand your diagnosis and support you in your treatment. Family psychoeducation programs help the person with schizophrenia and their family communicate better and solve problems. Family psychoeducation is also good for family members. It can be very upsetting to see someone you love become unwell with schizophrenia.

More about psychological treatments. ECT is a safe and effective treatment. It can be effective when symptoms of schizophrenia are very severe. If ECT is recommended as a treatment for you, your doctor should explain how it works and answer all your questions. Determining a diagnosis of schizophrenia may include:. Schizophrenia requires lifelong treatment, even when symptoms have subsided. Treatment with medications and psychosocial therapy can help manage the condition.

In some cases, hospitalization may be needed. A psychiatrist experienced in treating schizophrenia usually guides treatment. The treatment team also may include a psychologist, social worker, psychiatric nurse and possibly a case manager to coordinate care. The full-team approach may be available in clinics with expertise in schizophrenia treatment.

Medications are the cornerstone of schizophrenia treatment, and antipsychotic medications are the most commonly prescribed drugs. They're thought to control symptoms by affecting the brain neurotransmitter dopamine. The goal of treatment with antipsychotic medications is to effectively manage signs and symptoms at the lowest possible dose.

The psychiatrist may try different drugs, different doses or combinations over time to achieve the desired result. Other medications also may help, such as antidepressants or anti-anxiety drugs. It can take several weeks to notice an improvement in symptoms. Because medications for schizophrenia can cause serious side effects, people with schizophrenia may be reluctant to take them. Willingness to cooperate with treatment may affect drug choice.

For example, someone who is resistant to taking medication consistently may need to be given injections instead of taking a pill. These newer, second-generation medications are generally preferred because they pose a lower risk of serious side effects than do first-generation antipsychotics. Second-generation antipsychotics include:.

These first-generation antipsychotics have frequent and potentially significant neurological side effects, including the possibility of developing a movement disorder tardive dyskinesia that may or may not be reversible.

First-generation antipsychotics include:. These antipsychotics are often cheaper than second-generation antipsychotics, especially the generic versions, which can be an important consideration when long-term treatment is necessary. Some antipsychotics may be given as an intramuscular or subcutaneous injection.