Psychotic Symptoms / Schizophrenia

Finding The Right Treatment

Treatment for Schizophrenia

Schizophrenia is usually treated by a psychiatrist, but can also be treated by a nurse practitioner or physician’s assistant who is certified in psychiatry. Once a patient is diagnosed, they are typically treated with one or more psychiatric medications, including an antipsychotic. Sometimes the first medication a provider gives a patient is ineffective or has too many side effects. It’s important for patients starting new medication to stay in close contact with their provider regarding any possible allergic reactions or sudden worsening of symptoms. Keep in mind that this is not what every patient with Schizophrenia should expect when they start medication, but psychiatric providers are prepared to help patients accordingly.

Finding a therapist

Whether it be recognition of one's symptoms, an understanding of how one's past might have impacted them, or a simple awareness of thoughts and their triggers, working with a mental health clinician is a critical part of treatment and symptom stability. However, most people with schizophrenia cannot receive the full benefit of talk therapy until they are stabilized on their antipsychotic medication.

There are different kinds of professionals who can provide effective talk therapy:

• Clinical psychologists (PhD)
• Licensed clinical social workers (LCSW or LMSW)
• Licensed professional counselors (LPC)
• Licensed clinical professional counselors (LCPC)
• Licensed Marriage and Family Therapists (LMFT)

The decision to start therapy

Many people try to cope with their distress on their own, and then feel disappointed when they find that this is very difficult to do. Deciding to start therapy can be hard; it takes courage.

For some people, it can take time to warm up to the idea of sharing one’s intimate thoughts or disclosing details of one’s life, especially for those who grew up in a culture where seeking psychological help was frowned upon.

Psychotherapy is increasingly accepted as not only a way to improve mental health symptoms, but also a means for self exploration and personal growth. No problem is too small for a trained therapist: an individual need not worry that others may have it worse. The willingness to reach out for help is increasing: in 2020, one out of every six Americans (men and women) reported seeing a therapist.

Seeing a therapist with whom one feels comfortable, and a sense of connection, and who also participates in their insurance network, is essential. It may take a couple tries to find a therapist who feels like the right fit. If therapy didn't help the first time around, it can be helpful to give another therapist a try because therapeutic styles vary so much from therapist to therapist.

Where to start

Asking one’s physician to make a referral is often a good place to start. Many health insurance cards have websites or 1-800 numbers to call for a list of in-network providers.

To find a therapist who takes your insurance, the National Institute of Mental Health offers a comprehensive list of resources.

Psychology Today also lists therapists by type, location and insurance.

Medications used to treat schizophrenia

Medications are central in the lives of people with schizophrenia. Antipsychotics are the primary drugs used to treat schizophrenia. There are multiple medications available and most are in the form of tablets or capsules. Some antipsychotics are available as long-acting injections so that individuals need not remember to take medicine every day.

The table in your report shows a list of commonly prescribed antipsychotic medications that healthcare providers use to treat Schizophrenia. It’s not unusual for antipsychotic medication to cause metabolic changes, such as weight gain or changes in cholesterol levels. Patients with Schizophrenia can typically mitigate weight gain with healthy diet and exercise, but it may require adapting new lifestyle habits. It’s not unusual for patients to feel very sleepy when they first begin taking antipsychotic medication.

It may take several weeks to adjust to the chemical changes that take place, but typically the daytime sleepiness will improve with time. If a patient with Schizophrenia still struggles to stay awake on their medication after several weeks, they should speak with their psychiatric provider about adjusting the dosage. While rare, there are some instances where patients can experience involuntary muscle spasms or motor restlessness after taking their antipsychotic medication, in which case they should notify their provider right away.

Stopping medication

If an individual is taking antipsychotic medications, it is important for them to work with a prescriber in a collaborative way and to candidly share their questions, concerns, or any side effects they may have. If the decision is made to stop taking medication, for any reason, letting a provider know before proceeding is critical. Avoid abruptly stopping a medication, unless advised to do so by your prescriber. Individuals with schizophrenia who do not take their medication are at high risk of job loss, homelessness, substance abuse, and worsened health outcomes overall, and it’s important to know and understand those risks.

Healthcare providers that can prescribe medications

Psychiatrists, psychiatric nurse practitioners, and physician assistants are practitioners who are trained to diagnose and treat mental health conditions by prescribing medications. Sometimes it's hard to find a psychiatric provider because there are so many people who need them. So, individuals often choose to see a different kind of provider who can prescribe. This could be a doctor they already see, like a primary care doctor, family doctor or OB/GYN, or a new primary doctor.