A range of treatments can be used to treat the symptoms of schizophrenia.
These include:
- medicine
- psychological treatment (talk therapy)
- family support
- physical health monitoring and intervention
- occupational therapy
Some medicines are now available as an injection every 12 weeks. If you have an acute psychotic episode, antipsychotic medicine is usually recommended.
If there's a risk of future acute episodes, you may want to write an advance statement. This is instructions about what you would like your family or friends to do if you have another episode.
Your mental health team
Most people with schizophrenia are treated by a community mental health team (CMHT).
The team provides day-to-day support and treatment. They will make sure you have as much independence as possible.
Who is part of your CMHT
Team members can include:
- a social worker
- a community mental health nurse with specialist training in mental health difficulties
- an occupational therapist
- a pharmacists
- a counsellor or psychotherapist
- a psychologist
- a psychiatrist
- a peer support worker
Care plan approach
You may have complex mental health conditions.
Usually you'll work together with your healthcare team to develop a care plan.
A care plan is a way of making sure you receive the right treatment for your needs.
The care plan may involve a crisis plan. This is for an emergency.
Your care plan usually includes a healthy eating and physical activity programme.
If you smoke you can get help to quit smoking.
Your care coordinator will make sure all members of your healthcare team have a copy of your care plan.
Acute episodes
People who have serious psychotic symptoms may need a more intensive level of care.
You can use antipsychotic medicine and special care to treat these symptoms.
Antipsychotic medicine
Antipsychotics are usually recommended as the first treatment for an acute psychotic episode. They work by blocking the effect of dopamine, a chemical that sends messages in the brain.
Antipsychotics are not suitable or may not work well for everyone.
Talk to your GP or care team if you have:
- epilepsy - a condition that causes seizures or fits
- cardiovascular disease - a condition that affects the heart, blood vessels and circulation
They will monitor you for any side effects.
Antipsychotics can usually reduce feelings of anxiety and distress within a few hours of use. But they may take several days or weeks to reduce psychotic symptoms such as hallucinations or delusional thoughts.
Your doctor will give you a physical examination before you start antipsychotics. Talk to your psychiatrist about your symptoms and any other conditions you have. They will help you find the right antipsychotic for you.
Antipsychotics can be taken by mouth (orally) or given as an injection. There are several slow-release antipsychotics, where you only need 1 injection every 2 to 6 weeks.
Most people take medicine for 1 or 2 years after their first psychotic episode. This is to prevent more acute episodes. You can take medicine for longer if the difficulties return.
Types of antipsychotics
You and your psychiatrist can discuss the best antipsychotic for you. They can tell you about the likely benefits and side effects.
Antipsychotics can cause side effects, but not everyone will get them. The severity will differ from person to person.
Side effects can include:
- drowsiness
- shaking and trembling
- weight gain
- restlessness
- muscle twitches and spasms - where your muscles shorten tightly and painfully
- blurred vision
- dizziness
- constipation
- loss of sex drive (libido)
- dry mouth
Tell your psychiatrist or community mental health team (CMHT) if your side effects become severe. There may be another antipsychotic you can take. There may also be other medicines that will help you deal with the side effects.
If 1 antipsychotic medicine is not working for you, you can try a different one. It's important to work with your treatment team to find the right 1 for you. They will review your medicines at least once a year.
Do not stop taking antipsychotics without consulting your psychiatrist or CMHT. If you stop taking them, you could have a relapse (get symptoms again).
Psychological treatment (talk therapy)
Psychological treatment can help you cope with the symptoms. For example, hallucinations or delusions.
They can also help treat some of the negative symptoms of schizophrenia. For example, apathy or a lack of enjoyment.
Psychological treatments for schizophrenia work best when they're combined with antipsychotic medicine.
Common psychological treatments include:
- cognitive behavioural therapy (CBT)
- compassion focused therapy
CBT
Cognitive behavioural therapy (CBT) helps you manage difficulties by thinking more positively. It can help you change unhelpful patterns of behaviour.
Family supports
Many people with schizophrenia rely on family members for their care and support. Most are happy to help, but caring for somebody with schizophrenia can be difficult.
Behaviour family therapy
Family therapy is a way of helping you and your family cope better with your difficulty. You will have a series of informal meetings for about 6 months.
Meetings may include:
- discussing information about schizophrenia
- exploring ways of supporting somebody with schizophrenia
- deciding how to solve practical difficulties caused by symptoms of schizophrenia
Talk to your psychiatrist or CMHT about family therapy if you think it would be helpful.
Involuntary admission
In certain circumstances, you may have to be admitted to hospital without your agreement. This is called involuntary admission.
Content supplied by the NHS and adapted for Ireland by the HSE