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Schizophrenia Treatment Guidelines: An Essential Overview

Medically reviewed by

Written by Parth Sharma

What is Schizophrenia?

Schizophrenia is a chronic mental disorder that affects how a person thinks, acts, perceives reality, and relates to others. It involves psychosis, a mental illness wherein a person can’t tell what’s real from what’s imagined. 

A person with Schizophrenia can show a sudden change in personality and behavior, which happens when they lose touch with reality during a psychotic episode. In which the world may seem confusing, and thoughts, images, and sounds may seem messy. 

Causes of Schizophrenia

  Researchers believe that a combination of genetics, brain chemistry, and environment contributes to the development of schizophrenia.

Problems occurring in the brain chemicals such as neurotransmitters may contribute to schizophrenia. Neuroimaging studies show differences in the brain structure and central nervous system of people with schizophrenia. While researchers aren't sure about the significance of these changes, they indicate that schizophrenia is a brain disease.

Schizophrenia Diagnosis

Schizophrenia can be identified within a person based on the various symptoms, including delusions, Hallucinations, and Catatonia. 

Delusions. Delusions are defined as beliefs that conflict with reality. Delusions are the most common symptoms of schizophrenia and can be related to persecution, grandiosity, and somatic. 

Hallucinations. Hallucinations are defined as experiences and sensations that are not understandable to others. To the person experiencing them, however, they may seem tangible, urgent, and vivid. They are visual, auditory, olfactory, or tactile.

Catatonia. Catatonia refers to a set of symptoms that might develop. It includes periods where the person with schizophrenia moves very little and does not respond to instructions.

The diagnosis of Schizophrenia is made by determining how these symptoms are based on no other illness or disorder but due to Schizophrenia itself. 

A mental health professional can diagnose Schizophrenia through 

  1. Psychiatric Evaluation: This method includes learning about personal and family history. The mood, appearance, cognitive abilities, and thoughts of delusion and hallucination are observed.
  2. Physiological Tests: A physical exam is conducted by the doctors to rule out the symptoms of Schizophrenia to be due to substance abuse. They may also conduct neuroimaging. 
  3. DSM criteria: Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, is used by mental health professionals to diagnose symptoms of Schizophrenia based on its type, the period of recurrence, and its effects.

According to the DSM criteria, a person must have at least two of the following symptoms for a month:

  1. delusions
  2. hallucinations
  3. disorganized speech
  4. grossly disorganized or catatonic behavior
  5. negative symptoms, such as lack of speech, emotional flatness, or lack of motivation 

They must also experience considerable impairment in their ability to function in school or at work, interact with others, or carry out self-care tasks. They must have symptoms that persist for six months or more.

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Treatment for Schizophrenia 

“The first challenge to treating Schizophrenia is helping the individuals understand that they are fighting the disorder. This is called developing insight. Most treatment begins after insight is developed,” reflects Dr. Arun, Consultant Psychiatrist, Cadabams Group.

Schizophrenia is a chronic illness, and people with Schizophrenia often require lifelong support during their treatment. The two methods used to treat Schizophrenia are medication and therapy. Caregivers for people with Schizophrenia give consent to supported admission for the treatment of their loved one at a hospital or clinic if and when in the event of a violent psychotic episode; the person is at risk of hurting themselves or the people around them. 

Medication for Schizophrenia

The antipsychotic medication for Schizophrenia is a widely used method of treatment. The goal of treatment with antipsychotic drugs is to manage signs and symptoms at the lowest possible dose effectively. The medication can be administered orally or via injections.

Oral medication

First Generation Antipsychotic medications are cheaper medications in the long run but have significant neurological side effects on the body. Second-generation antipsychotic medications such as Aripiprazole (Abilify), Asenapine (Saphris), Brexpiprazole (Rexulti), and Cariprazine (Vraylar) are thus widely used due to their lower risk of side effects. 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 instance, someone resistant to taking medication in time may need injections instead of taking a pill. 

Different atypical antipsychotics may cause different side effects. Some common issues may include Weight gain, Higher blood sugar and cholesterol levels, Low blood pressure, Drowsiness, and blurry vision.

Injectable Antipsychotics

Antipsychotics can be given as an intramuscular or subcutaneous injection. They are usually given every two to four weeks, depending on the medication. This may be an option if someone prefers fewer pills and may help with adherence if the person cannot follow medicines as per the recommended routine. 

Therapy for Schizophrenia 

While medication helps relieve symptoms of schizophrenia, various psychosocial treatments can help with the behavioral, psychological, and social dysfunctions that go with the illness. Through therapy, people with schizophrenia can also learn to manage their symptoms, identify early relapse warning signs, and develop a relapse prevention plan. 

Cognitive Behavioural Therapy (CBT).

Cognitive Behavioural Therapy helps the person change their thinking and behavior. The symptoms of schizophrenia are often delusions and hallucinations, where the person may feel disconnected from reality. With a combination of CBT sessions and medication, people with schizophrenia can identify their lack of control as a symptom of schizophrenia instead of the paranoia of hearing and seeing things. Therapy allows one to identify what triggers their psychotic episodes and how to reduce or stop them. 

Electroconvulsive Therapy (ECT).

Electroconvulsive therapy is a procedure done under general anesthesia. Small electric currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental health conditions such as Schizophrenia, Mood Disorders. ECT often works when other treatments are unsuccessful, and the entire course of treatment is completed, but it may not work for everyone.

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Family Therapy.

People with schizophrenia often rely on family members for their primary care and support. Caregiver burnout and exhaustion can strain any family, with caregivers feeling guilty for taking time off for their own life or being abandoned by their loved one seeking treatment for schizophrenia. Family therapy is a way of helping the caregiver and their loved one cope better with their condition. It involves a series of meetings for around six months. Sessions may include:

  • Discussing information about schizophrenia.
  • Exploring ways of supporting somebody with schizophrenia.
  • Deciding how to solve problems that the symptoms of schizophrenia can cause within family settings.

 Schizophrenia is a chronic condition that significantly impacts a person’s ability to function in life. Schizophrenia has no cure, though a varied treatment for it is available to help one manage their symptoms. People with schizophrenia benefit considerably from the support of their family, friends, and community services. They benefit from medication and treatment and can recover from this illness. 

How do we help?

A loved one is fighting Schizophrenia, and you are looking for treatment options. You run through hospitals, professionals, centers changing each as the nature and severity of the illness change. It’s harrowing.

That is where we come in. We have built a comprehensive mental healthcare infrastructure that promises to cater to all of your treatment needs. Once you step into Cadabams, you will never need to go anywhere else. From OPD consultations, hospitalization to personalized rehabilitation plans, we offer it all. 

At Cadabams, we’ve got you covered.

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