Treatment
After a schizophrenia diagnosis the doctor will have a conversation with the person diagnosed about starting a treatment plan. Once treatment begins, there are two main goals to work together with the doctor towards: reducing frequency and severity of acute psychotic episodes and improving quality of life.1
 
Guidelines on treatment, such as those from NICE, encourage early intervention whenever the first symptoms are noticed, because this can decrease the risk of developing psychosis.2
The doctor will discuss options with the person with schizophrenia, in order to choose the best type of medication to fit their needs. Ultimately, the choice will be made based on medical history, phase of treatment and side effects which may be expected with the pharmacological treatment.2
 
However, the treatment people with schizophrenia receive is not limited to a pharmacological approach. A system called “multi-modal treatment” is in place. This means that the treatment will likely cover, on top of antipsychotic medication, the following: 1 
Psychotherapy
Social skills training
Personal education
Family intervention, training
Schizophrenia treatment depends on the person being treated but is  usually a combination of therapy and medication. While there is not  currently a cure for schizophrenia, many symptoms can get better with  treatment and some people find that their symptoms may stop altogether.   
If you have schizophrenia you may be treated with:
Cognitive Behavioural Therapy (CBT)
CBT is a type of therapy that can help you recover from ongoing  positive and negative symptoms  of schizophrenia. It helps you to  identify the thinking patterns which  may be causing you to have unwanted  feelings or behaviour and to  replace these with more realistic  thoughts.12  
 
You  may need between 8-20 sessions of CBT over 6-12 months, however  this  can vary. Each session usually lasts about half an hour.12 
Arts Therapy
Arts therapy can help you to express your experience with   schizophrenia. Sometimes the negative symptoms of schizophrenia mean you   may find it difficult to relate to others.13 Arts therapy can be a good way to share your feelings and may even help to give you a new outlook on schizophrenia.12 
Family Therapy
Family can play an important role in helping to manage your   schizophrenia. However, sometimes it can be challenging for family   members. Family therapy can help you and your family understand and cope   better with your schizophrenia. It involves discussion with an expert   on ways to provide support and practical tips on how to deal with any   problems. Family therapy can be especially helpful if you have recently   experienced an acute episode. 12,13
Medication
Your doctor may prescribe antipsychotic drugs for your symptoms  of  schizophrenia. The type of drug depends on your symptoms and will  only  be given to you after an examination by your doctor. These  medications  may be oral pill-based or sometimes given as an injection.12   Generally antipsychotic medication can be classed as first generation   or second generation. Speak to your doctor for more information about   the differences between these two groups of medications.  
 
The  amount of time you may be asked to take medication can vary. While   some side effects can be expected, if they become severe make sure that   you tell your doctor. There may be alternative medication or additional   medications that can help.12 
 
It  is important that you do not stop taking any antipsychotic  medication  without first consulting your doctor. If you do stop, your  symptoms may  get worse. 12
What is medication adherence and why is it important?
Good medication adherence means that the person with schizophrenia   complies to taking the medication exactly as prescribed by their doctor.3   This can be hard for a lot of people living with schizophrenia – in   particular, their reported adherence to medication is around 50%, which   means they fail to take half their medication as indicated.3-5
People living with schizophrenia may find the number and frequency of   medicines too hard to remember, or a medicine may have certain side   effects which are too uncomfortable, leading to discontinuation. 6-9 It may also be difficult for them to maintain treatment consistency when they think it’s no longer necessary.9
If  people with schizophrenia find that they’re struggling to take their   medicines, they should speak to their doctor to consider different   options for them.  
Skipping medication or taking a different dosage is the main reason why people relapse and experience new psychotic episodes.9
Treating negative symptoms
Negative symptoms are common for people living with schizophrenia.10 These symptoms are presented with reduced desire to speak, socialise, or take part in everyday activities.10 
Unfortunately,  even second generation drugs for schizophrenia (called  atypical  antipsychotics) haven’t been able to fully tackle negative  symptoms.10 
In   general, the current types of treatment aim at resolving the positive   symptoms (psychosis and acute episodes) and only after this is achieved   there is a relative improvement in negative symptoms.11 
Negative  symptoms can interfere with a person’s quality of life, so  it’s  extremely important to talk about these with a doctor early on.10 
Evidence-based guidelines for the pharmacological treatment of schizophrenia: recommendations from the British Association for Psychopharmacology
References
- Haller CS, Padmanabhan JL, Lizano P, Torous J, Keshavan M. Recent advances in understanding schizophrenia. F1000Prime Rep. 2014 Jul 8;6:57
- NICE CG178 https://www.nice.org.uk/guidance/cg178. [accessed August 2019]
- Bebbington PE. Int Clin Psychopharm 1995;9(Suppl.5): 41–50
- Cramer JA. Psychiatr Serv 1998;49: 196–201
- Velligan DI. Schizophr Bull 2006;32:724–742
- Byerly MJ. Psychiatric Clin North America 2007;30: 437–452
- Mitchell AJ Adv Psychiatr Treat 2007;13: 336–346
- Barnes TR and the Schizophrenia Consensus Group of the British Association for Psychopharmacology. J Psychopharmacol. 2011;25(5):567-620
- Weiden PJ. J Clin Psychiatry 2007;68(Suppl. 14): 14–19
- Sicras-Mainar A. Neuropsychiatr Dis Treat 2015:11 51–57
- Sicras-Mainar A, Maurino J, Ruiz-Beato E, Navarro-Artieda R. Impact of negative symptoms on healthcare resource utilization and associated costs in adult outpatients with schizophrenia: a population-based study. BMC Psychiatry. 2014 Aug 6;14:225
- NHS, Treatment Schizophrenia, 2016. https://www.nhs.uk/conditions/schizophrenia/treatment/ [Accessed October 2019]
- NHS, Symptoms, 2016. https://www.nhs.uk/conditions/schizophrenia/symptoms/ [Accessed October 2019]
- NICE, Psychosis and schizophrenia in adults: prevention and management, 2014. https://www.nice.org.uk/guidance/cg178/chapter/1-Recommendations#subsequent-acute-episodes-of-psychosis-or-schizophrenia-and-referral-in-crisis-2 [Accessed October 2019]
Schizophrenia: how can I help?
Learning about schizophrenia is important in order to understand the phases, the symptoms and what a person may be going through. There is a lot of wrong inform
more…Schizophrenia and personal life
Everyone who has schizophrenia will experience it differently. Presentation and severity of symptoms can vary, however they are likely to affect the personal li
more… 
 

