What Are the Treatments for Schizophrenia?

During a first episode or relapse of psychosis, taking antipsychotic medication reduces the immediate thoughts and behaviors related to the episode. This is effective for the vast majority of people.

Most people will benefit from using medication continuously. Medication can help manage your symptoms and prevent relapse. The improvements are usually fastest within the first 2 weeks, but they can continue to improve over several weeks or months.

Choosing a medication will be a decision made between you and your doctor. A friend, partner, or caregiver may also be part of this decision. Before you start, your doctor should tell you about any possible side effects, how long they might last, and how to manage them.

There are two main classes of antipsychotic medications: typical antipsychotics and atypical antipsychotics.

Typical antipsychotics

Available since the 1950s, traditional or typical antipsychotics primarily block dopamine receptors and effectively control the hallucinations, delusions, and confusion related to schizophrenia.

Typical antipsychotics include:

• chlorpromazine (Thorazine)
• fluphenazine (Prolixin)
• haloperidol (Haldol)
• loxapine (Loxitane)
• perphenazine (Trilafon)
• thiothixene (Navane)
• trifluoperazine (Stelazine)

While they help keep your symptoms in check, antipsychotics come with various side effects of their own. Managing these side effects is another important part of treatment.

Some people experience mild side effects from typical antipsychotics. These usually disappear a few weeks after treatment starts. They might include:

• dry mouth
• blurred vision
• constipation
• drowsiness
• dizziness

More serious side effects can include:

• fidgeting
• muscle cramps or spasms
• unintended muscle movements

For example, you might stick out your tongue, lick your lips, or wave your arms without meaning to. This is known as tardive dyskinesia.

Some side effects can be difficult to manage, but it’s important to talk with your doctor before stopping or making any changes to your medication.

There’s a high risk of symptoms returning after stopping medication. You and your doctor together can figure out an effective solution.

Atypical antipsychotics

Atypical antipsychotics were introduced in the 1990s. Some of these medications might work on both serotonin and dopamine receptors. Because of this, they might treat positive and negative symptoms of schizophrenia.

Atypical antipsychotics include:

• aripiprazole (Abilify)
• asenapine (Saphris)
• clozapine (Clozaril)
• iloperidone (Fanapt)
• lurasidone (Latuda)
• olanzapine (Zyprexa)
• paliperidone (Invega)
• risperidone (Risperdal)
• quetiapine (Seroquel)
• ziprasidone (Geodon)

These medications are less likely to cause movement disorders. They can have different side effects, such as:

• weight gain
• type 2 diabetes
• sexual dysfunction
• sleepiness or sedation
• an irregular heart rate

Changing your diet and exercise routine, and sometimes taking additional medication, can reduce the risk of these side effects.

Read more about atypical antipsychotics for treating schizophrenia here.

Long-acting injectable medication

Schizophrenia medication comes in the form of pills you take every day or as a long-acting injectable (LAI).

LAI is used with atypical antipsychotics. You receive them every few weeks or months. People often prefer this option, as it makes taking medication easier.

Read more about long-acting treatments for schizophrenia here.

Treatment-resistant schizophrenia

In up to 34% of people with schizophrenia, the condition doesn’t respond to two or more courses of antipsychotics. This is known as treatment-resistant schizophrenia.

Currently, the only known effective treatment for this is clozapine, an atypical antipsychotic. The side effects of clozapine can be more difficult to manage than other medication side effects.

The more serious side effects might include inflammation in the heart and agranulocytosis. Agranulocytosis is a serious blood disorder.

The good news is that careful monitoring, such as regular blood tests, can minimize these side effects. In recent years, personalizing clozapine treatment has improved this treatment.

While medication can help with many symptoms, they don’t address all aspects of schizophrenia.

Talk therapy, or psychotherapy, can help you and your loved ones better understand and navigate this condition and its effects on your lives.

Many types of psychotherapy can reduce your symptoms, help with day-to-day activities, and improve your quality of life.

Types of psychotherapy used for schizophrenia include the following:

• Cognitive behavioral therapy (CBT) helps you build coping methods for symptoms that medication doesn’t resolve. CBT can also help you identify and achieve goals, both in treatment and in daily life.
• Acceptance and commitment therapy aims to improve your quality of life by helping you tolerate your symptoms. It’s based on mindfulness. For example, you might learn to accept auditory hallucinations by being open, curious, accepting, and nonjudgmental toward them.
• Cognitive enhancement therapy (CET) helps you gain confidence in your cognitive ability using brain training games and group sessions. The National Alliance on Mental Health (NAMI) notes this is an active area of research.
• Peer support groups, like NAMI’s Peer-to-Peer, can allow you to talk with people who have similar experiences to you. This can help with social skills and build a sense of shared community.
• Family therapy encourages loved ones to call a family meeting whenever an issue arises so everyone can talk about the problem, make a list of ways to fix it, and collaborate to find the best solution for everyone.
• Group therapy can help you improve your social skills, work skills, relationships, and ability to stick with treatment. Group therapy can prevent you from feeling isolated and can help with reality testing.
• Assertive community treatment is a comprehensive, community-based program that can help if you have a risk of hospitalization and trouble staying in treatment. You might see case managers, psychiatrists, and social workers as part of this treatment.

Keeping up with medications can be difficult for many people. You might feel the medication isn’t working, that the side effects are too much, or the medications are expensive.

Remember, following your treatment plan consistently is important for staying well. You can reach out to your doctor or therapist if you feel the medication isn’t working. They can offer advice about adjusting the dose or type of medication.

Some organizations offer advice on how to get support in accessing treatments for schizophrenia.

The NAMI offers advice on how to get help paying for medications. The Anxiety and Depression Association of America (ADAA) offers advice on low-cost treatment.

People with schizophrenia are more likely than people without the condition to have substance use disorders. This might include tobacco, alcohol, cannabis, or cocaine use disorders.

It’s important to get treatment for any substance use disorders at the same time as your schizophrenia treatment. Substance use disorders can make schizophrenia treatment more complicated.

While it’s tempting to focus on the challenges of schizophrenia, it’s important to remember that you have many personal strengths that you can bring to treatment.

Many people with schizophrenia are able to live with minimal symptoms and have happy, fulfilling lives. Though it’s not always easy to stick to, making time for self-care can have major benefits for your overall mood and well-being.

You might find that the following self-care tips help:

• Talk with people who’ve had similar experiences. Having schizophrenia can feel very isolating at times, so it can help to know that you’re not alone. Support groups, online or in person, provide validation and community. They can also help you expand your coping tools and strategies.
• Open up to friends and therapists. It can be difficult to talk about experiences that people without schizophrenia don’t have, like auditory or visual hallucinations. If you feel safe enough to do so, talking about how you’re feeling can help validate your experiences, reality test, and reduce the power these symptoms can have.
• Reduce stress. For many people, stress can worsen symptoms or trigger an episode. It can help to identify people, places, and situations that cause stress, and work out ways to manage them safely.
• Make a plan for difficult times. When you’re feeling well, plan ahead on how to deal with challenging times, episodes, and crises. This can help reduce their impact.
• Learn to manage auditory hallucinations. If you hear voices, the key to getting better isn’t to stop hearing them — it’s to learn to interpret and interact with them. A mental health charity, Mind, offers helpful information on managing this symptom. To get the perspective of someone with schizophrenia, check out this TED Talk by Eleanor Longden.
• Set small goals. Think about what you want and value in life. Then, together with a loved one or therapist, work out small steps to make them happen.
• Do what you love. Make time to do the things you love. What makes you happy? What helps you relax? Doing things you enjoy will help relax your mind and body.

Sometimes, visiting the hospital is the best option for helping you feel stable and recover from an episode of psychosis.

Staying in a hospital is common for many people’s first episode of psychosis. If your symptoms are severe, the hospital might become a familiar place where you can get help and start feeling better.

This might help when you’re having severe delusions or hallucinations, are unable to care for yourself, or if there’s a risk of harm to yourself or others.

If you’ve had a hospital visit, your doctor or therapist might change or adjust your medication and help you work out a crisis plan for the future. The hospital generally provides a medical evaluation and therapeutic interventions.

According to a 2019 study, having another condition — such as a substance use disorder, bipolar disorder, or depression — can make hospital visits more likely.

If you’re not aware that your symptoms have become severe, which is relatively common during an episode of psychosis, a loved one or therapist might request that you get taken to hospital. Different U.S. states have different laws about involuntary hospital stays.

Most hospital stays are short term, from several days to several weeks. It depends on the severity of symptoms and your access to treatment outside the hospital.

This information sheet about hospitalization provides more information on why someone might need hospitalization, how they can benefit, and what loved ones can do to make the hospital stay as easy as possible. It also includes hospital experiences from people with schizophrenia and their loved ones.

If someone close to you has a mental health condition such as schizophrenia, it can help to show them that you believe in their ability to get better, and to support them to apply and grow their strengths.

Here are some ways you can help:

• Ask them what they need. Talk with your loved one about what having schizophrenia is like for them. Ask them how you can support them.
• Learn more about the condition. There are many resources available, including blogs written by people with schizophrenia, self-help books, and videos.
• Listen with empathy. Keep the lines of communication open about problems, concerns, or fears they might have.
• Help them build a routine. Plan a daily routine with them, making sure to include times for relaxation and activities they enjoy. You can plan things to do together, too, like going for walks or playing games.
• Help write a plan for dealing with episodes. This might include a list of early signs, tactics for navigating episodes, healthy coping tools, and the names and numbers of professionals to call when needed.
• Help them maintain their treatment plan. This can include giving them an easy-to-use pillbox, creating reminders or alarms, helping them keep track of their symptoms or side effects, and encouraging them to engage with treatment.
• Applaud their hard work — and your own, too. Show them that you’re proud of their efforts and progress, including the small steps they take. Celebrate your own efforts to help them in their journey to better well-being.

Looking for more? Check out these ways you can help a loved one with schizophrenia.

Joining a support group for family and friends of people with schizophrenia is a great way to share common experiences and learn strategies to best deal and work through any feelings you have. Remember, it’s important to take care of your mental health, too.

Start your search for a local support group at NAMI.

For more help, check out organizations that offer resources and support for people with schizophrenia and their families, such as:

• Schizophrenia and Related Disorders Alliance of America (SARDAA)
• Mental Health America (MHA)