July 19, 2022
5 min. read

Schizophrenia: Know Your Medication Treatment Options

Medly

Good to Know:

  • Schizophrenia is a serious mental condition that requires ongoing treatment. The most common schizophrenia treatment is antipsychotic medications.
  • There are two classes of antipsychotic medications: second-generation antipsychotics and first-generation antipsychotics. First-generation antipsychotics are used less often because they can cause serious side effects.
  • Medication is essential to schizophrenia treatment, but many patients see success with psychotherapy as well.
  • If you or a loved one is struggling with this complicated mental health disorder, it’s important to work together with healthcare professionals to find the most effective treatment plan.

Schizophrenia is both a mental disorder and a spectrum of mental health conditions called psychotic disorders. As a mental disorder, schizophrenia is a complex condition that requires lifelong treatment, but it is possible to manage your mental health with schizophrenia. By finding and consistently using the right treatment plan, patients with schizophrenia can manage their symptoms.

Quick Statistics: It’s estimated that between 0.25%-0.64% of adults in the U.S. are living with schizophrenia, according to the National Alliance on Mental Illness. 

Schizophrenia is connected to psychosis, but there are some distinct differences. Psychosis includes a psychotic break or disconnect from reality, and it can happen with other mental health conditions such as bipolar disorder. Schizophrenia includes a range of conditions that involve psychotic symptoms, such as delusions and hallucinations.

How do I know if a loved one has schizophrenia?

Although they may appear at any age, symptoms of schizophrenia don’t typically appear until late adolescence to adulthood. Men usually show symptoms in their late teens to twenties, while women may not show symptoms until their early thirties. Having a family member with a history of schizophrenia leads to increased risk of developing the disorder.

Symptoms of schizophrenia usually happen in a pattern: onset, active, and residual. During the onset stage, a loved one may show symptoms such as anxiety, withdrawal, and neglecting their health and hygiene. 

The active stage is also called a “psychotic break,” and it indicates when a person has disconnected from reality. Symptoms of this stage include hallucinations, delusions, disorganized speaking or movements, and incoherent speech. It’s also common for people with schizophrenia to feel anxious, paranoid, or afraid. 

Fast Facts: In pop culture, schizophrenia is sometimes conflated with dissociative identity disorder, previously called “multiple personality disorder.” While these are both serious mental health concerns, they are not the same; schizophrenia does not include multiple personalities.

The final stage is the residual stage, where symptoms are still present but not as severe. Some patients may even seem mostly or fully recovered, but without the appropriate treatment plan, they will eventually return to the active stage of schizophrenia. People with schizophrenia may also struggle with other health concerns. These may include anxiety, depression, and substance use as an attempt to self-medicate.

If you or your loved one has been diagnosed with this condition, working with experienced healthcare professionals, including mental health experts, will help minimize the disease’s impact and help you and your loved ones live healthy lives.

Medication: the key to successful schizophrenia treatment

While schizophrenia can’t be cured, you can manage schizophrenia symptoms with the right kind of treatment. For most patients with schizophrenia, this will include medication. The Mayo Clinic even calls medication “the cornerstone of schizophrenia treatment.”

Antipsychotic medication is the most commonly used medication for treatment of schizophrenia. There are two main types of antipsychotic medications: first-generation antipsychotics and second-generation antipsychotics.

First-generation antipsychotic medications

First-generation antipsychotics are also called typical antipsychotics. These drugs affect the levels of dopamine in the brain.

First-generation antipsychotics have the risk of serious side effects. This includes a movement disorder known as tardive dyskinesia. It’s caused by medications blocking dopamine in the brain, and it causes involuntary movements of the jaw, mouth, and tongue. Sometimes tardive dyskinesia is reversible; other times it’s permanent.

Fast Facts: Patients may also have a movement disorder for a short period of time when taking typical antipsychotics. This is called dystonia.

Examples of first-generation antipsychotics include:
  • Chlorpromazine (Thorazine)
  • Fluphenazine (Proxlixin)
  • Haloperidol (Haldol)
  • Perphenazine (Trilafon)
  • Thiothixene (Navene)

Second-generation antipsychotic medications

These medications are newer than first-generation antipsychotics. Also called atypical antipsychotics, they affect dopamine and serotonin levels in the brain. 

Second-generation antipsychotic medications are usually prescribed first in schizophrenia treatment, as they have a lower risk of serious side effects than first-generation antipsychotics. They aren’t without their own side effects, however; atypical antipsychotics increase the risk of metabolic syndrome, diabetes, and weight gain. Incorporating lifestyle changes into schizophrenia treatment can help reduce these side effects.

Examples of second-generation antipsychotics include:
  • Aripiprazole (Abilify)
  • Asenapine (Saphris)
  • Olanzapine (Zyprexa)
  • Paliperidone (Invega)
  • Quietapine (Seroquel)
  • Risperidone (Risperdal)
  • Ziprasidone (Gendon)

Another atypical antipsychotic is clozapine, also called Clozaril or Versacloz. It’s the first FDA-approved antipsychotic for treatment-resistant schizophrenia, and it can also reduce suicidal thoughts or behaviors. There are some rare but serious side effects to clozapine, including the possibility of movement disorders.

Fast Facts: Cigarette smoke can decrease the levels of clozapine by as much as 50%. If you or your loved one smokes cigarettes, take steps to quit to ensure schizophrenia treatment will be as effective as possible.

The significance of psychotherapy

The American Psychological Association states that psychotherapy is integral to schizophrenia treatment. Cognitive behavioral therapy, or talk therapy, can help patients understand and normalize their thought patterns. It can also help them learn how to handle stressful situations, as well as what to look for in early signs of relapse (coming out of the residual stage and back into the active stage). Support groups and family therapy can help patients and their family members receive education and support while dealing with schizophrenia.

Patients with schizophrenia may also need social skills training. This focuses on improving social interactions and healthy communication, and it improves patients’ abilities to function in their daily lives. With treatment, patients can work, care for themselves, and lead fulfilling lives.

Did You Know? Some patients see success with antidepressants or anti-anxiety medications as part of a schizophrenia treatment plan.

How loved ones can help

It’s not uncommon for patients with schizophrenia to feel hesitant about seeking treatment. The potentially serious side effects of schizophrenia medication can be concerning. In addition, an estimated 50-90% of patients with schizophrenia also show signs of anosognosia. This condition is described as a “lack of insight,” meaning patients with schizophrenia don’t realize they have a mental condition. They will not notice the symptoms of schizophrenia, and especially when paired with schizophrenic delusions and paranoia, finding and committing to an ongoing treatment plan can be a challenge.

If a loved one or family member is showing signs of schizophrenia, encourage them to see a mental health provider or someone else who can help. By talking with someone who can help, the person may recognize they have a mental disorder and seek the needed treatment. If they talk about thoughts of suicide, or hurting themselves or other people, seek emergency care immediately.

Sources

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