The causes of schizophrenia remain unclear, thus treatment consists of addressing symptoms, rather than correcting the underlying causes of the disease. In former times, patients who likely suffered from schizophrenia were highly stigmatized and were often shut away in prison-like institutions.
Today, mental health professionals routinely manage patients’ symptoms and disease-related disabilities with older (typical) antipsychotic medications or newer second-generation (atypical) antipsychotic medications. Treatment of concomitant conditions, such as depression, may warrant therapy with other drugs, such as antidepressants.
In some cases, management of schizophrenia also involves the use of various psychosocial treatments. Psychosocial treatments are often employed after patients have been stabilized on antipsychotic medication(s). These treatments are designed to assist patients with the daily challenges of living and reintegrating into society. They provide coping mechanisms that help patients with communication, work, social and personal relationships, self-care and grooming, attending school, etc.
Experience has shown that providing these support services helps increase the likelihood that patients will continue taking their medication as directed. Patients receiving psychosocial treatments are less likely to relapse or be readmitted to the hospital. An important aspect of therapy involves educating the patient and his or her family members about the illness and providing strategies for coping with any persistent symptoms. Management of the disease has progressed to the point that many patients are able to lead productive lives.
Occasionally, mental health professionals recommend
cognitive-behavioral therapy (CBT) for schizophrenia patients whose specific
symptoms (such as auditory hallucinations) persist, despite medication. CBT
focuses on teaching patients to change their thinking and behavior. Such an
approach might coach a patient to evaluate the objective reality of his
thoughts and sensory perceptions, for example, or to ignore the persistent “voices” in his head, to better manage the effects of his disease.
Substance Abuse Treatment
Because substance abuse is the most common problem likely to accompany a diagnosis of schizophrenia, simultaneous drug abuse treatment may also be necessary. Treating both the illness and the drug abuse results in better outcomes for patients than treating one or the other problem alone.
Electroconvulsive therapy (ECT), sometimes referred to as “electroshock therapy,” is an accepted alternative treatment for schizophrenia, especially in severe cases or instances where drug treatment has proven ineffective. Despite its unsavory reputation in the United States, ECT has long been used to treat schizophrenia in Europe. Contrary to common misconceptions about the procedure, ECT is safe and does not cause brain damage. Some recent studies—based on research in the United States and abroad—have supported the use of ECT in the treatment of schizophrenia, indicating that it may speed recovery and improve response to medications. These studies noted, however, that antipsychotic drug therapy is still considered first-line treatment. ECT may play a complementary role to drug therapy, therefore.
Transcranial Magnetic Stimulation
An alternative to ECT is gaining traction among some experts. Transcranial Magnetic Stimulation (TMS), which employs pulses of powerful magnetic fields across the skull, has been shown to improve symptoms of schizophrenia in some preliminary investigations. TMS is viewed as potentially less objectionable than ECT, while equally effective.