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Treatments and drugs
By Mayo Clinic staffCatatonic schizophrenia is a chronic condition that requires lifelong treatment, even during periods when you feel better and your symptoms have subsided. Treatment can be challenging because you may feel as if you don't need treatment, and you may refuse to follow treatment recommendations. But effective treatment can help you take control of your condition and enjoy a happier and healthier life.
Treatment options are generally similar for all types of schizophrenia. But the specific treatment approach that's best for you depends on your particular situation and the severity of your symptoms.
Treatment teams
Catatonic schizophrenia treatment is usually guided by a psychiatrist skilled in treating the condition. But you may have others on your treatment team as well because the condition can affect so many areas of your life. Your treatment team can help make sure that you're getting all of the treatment you need and that your care is coordinated among all of your health care providers.
The team involved in treatment of catatonic schizophrenia may include your:
- Family or primary care doctor
- Psychiatrist
- Psychotherapist
- Pharmacist
- Family members
- Case worker
- Psychiatric nurse
- Social worker
Main treatment options
The main treatments for catatonic schizophrenia are:
- Medications
- Electroconvulsive therapy (ECT)
- Hospitalization
- Psychotherapy
- Vocational skills training
Medications for catatonic schizophrenia
Medications are one of the cornerstones of catatonic schizophrenia treatment. Those most commonly prescribed for catatonic schizophrenia include:
- Benzodiazepines. These medications, also called anti-anxiety medications, are sedatives. They are generally the medication of choice to treat catatonic schizophrenia. Benzodiazepines, which may be injected in a vein — especially if you're in a state of catatonia — are typically fast acting, helping relieve catatonic symptoms quickly. They may cause dependency with long-term use. These medications may also help if you have anxiety along with catatonic schizophrenia. You may need to take benzodiazepines for a period of days or weeks to relieve your catatonic symptoms.
- Barbiturates. These medications also are sedatives and have a similar effect as benzodiazepines, quickly relieving catatonic symptoms. They, too, may be habit-forming with long-term use. They're generally not routinely used to treat catatonic schizophrenia.
- Other medications. It's common to have other mental health issues along with catatonic schizophrenia. Antidepressants can be helpful if you have symptoms of depression. And mood-stabilizing medications may help with aggression or hostility.
- Antipsychotic medications. These are generally the medication of choice for schizophrenia. However, they aren't used as often for the catatonic type of schizophrenia because they can actually worsen catatonic symptoms.
Choosing a medication
In general, the goal of treatment with medications is to effectively control signs and symptoms at the lowest possible dosage. Which medication is best for you depends on your individual situation. Benzodiazepines and barbiturates may help quickly relieve your catatonic state and may be used on an emergency basis in the hospital. But it can take several weeks after first starting other medications to notice an improvement in your other symptoms, such as depression or anxiety.
If one medication doesn't work well for you or has intolerable side effects, your doctor may recommend combining medications, switching to a different medication or adjusting your dosage. Don't stop taking your medication without talking to your doctor, even if you're feeling better. You may have a relapse of psychotic symptoms if you stop taking your medication. In addition, some medications need to be tapered off, rather than stopped abruptly, to avoid withdrawal symptoms.
Electroconvulsive therapy (ECT) for catatonic schizophrenia
Electroconvulsive therapy (ECT) is a procedure in which electric currents are passed through your brain to trigger a brief seizure. This seems to cause changes in brain chemistry that can reduce symptoms of certain mental illnesses, such as catatonic schizophrenia. ECT may be an option for you if your symptoms are severe or if medications haven't helped relieve a catatonic episode. Deciding whether electroconvulsive therapy is a good option for you can be extremely difficult. If possible, make sure you or your guardian understand all the pros and cons.
Hospitalization for catatonic schizophrenia
During crisis periods or times of severe catatonic symptoms, hospitalization may be necessary. This can help ensure your own safety and that of others, and make sure that you're getting proper treatment, nutrition, sleep and hygiene. Partial hospitalization and residential care also may be options.
Psychotherapy for catatonic schizophrenia
Although medications are the cornerstone of catatonic schizophrenia treatment, psychotherapy also is important. Psychotherapy may not be appropriate for everyone, though, especially if symptoms are too severe to engage in a therapeutic process that requires two-way communication. Psychotherapy may include:
- Individual therapy. Psychotherapy with a skilled mental health provider can help you learn ways to cope with the distress and daily life challenges brought on by having a chronic mental illness like catatonic schizophrenia. Therapy can help improve communication skills, relationships, your ability to work and your motivation to stick to your treatment plan. Learning about catatonic schizophrenia can help you understand it better, cope with lingering symptoms, and understand the importance of taking your medications. Therapy also can help you cope with stigma surrounding catatonic schizophrenia.
- Family therapy. Both you and your family may benefit from therapy that provides support and education to families. Your symptoms have a better chance of improving if your family members understand your illness, can recognize stressful situations that might trigger a relapse, and can help you stick to your treatment plan. Family therapy can also help you and your family communicate better with each other and understand family conflicts. Family therapy also can help family members cope and reduce their distress about your condition.
Social and vocational skills training for catatonic schizophrenia
Training in social and vocational skills to live independently is an important part of recovery from catatonic schizophrenia. With the help of a therapist, you can learn such skills as good hygiene, cooking and better communication. Many communities have programs that can help you with jobs, housing, self-help groups and crisis situations. If you don't have a case manager to help you with these services, ask your doctors about getting one.
Treatment challenges in catatonic schizophrenia
When you have appropriate treatment and stick to your treatment plan, you have a good chance of leading a productive life and functioning well in daily activities. But be prepared for challenges that can interfere with treatment.
For one thing, you, like many others with schizophrenia, may find it hard to follow your treatment plan. You may believe that you don't need medications or other treatment. Also, if you're not thinking clearly, you may forget to take your medications or to go to therapy appointments. Talk to your doctors about tips to stick to your treatment plan. Even with good treatment, you may have a relapse. Have a plan in place to deal with a relapse.
Smoking, and often heavy smoking, is common when you have schizophrenia. Some evidence suggests that smoking improves thinking and concentration in schizophrenia. But smoking can interfere with certain medications. Be honest with your doctors about your smoking habits. And be sure you understand the serious health risks of smoking.
Similarly, using alcohol and drugs can make catatonic schizophrenia symptoms worse. If you have a problem with alcohol or substance abuse, you may benefit from treatment programs that include care for both schizophrenia and substance abuse.
- Schizophrenia and other psychotic disorders: Catatonic type. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Oct. 30, 2008.
- Minzenberg MJ, et al. Schizophrenia. In: Hales RE, et al, eds. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Publishing Inc.; 2008. www.psychiatryonline.com. Accessed Oct. 7, 2008.
- Schizophrenia. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/schizophrenia/complete-publication.shtml. Accessed Oct. 27, 2008.
- Jibson MD, et al. Schizophrenia and related disorders. http://www.uptodate.com/home/index.html. Accessed Oct. 1, 2008.
- Schizophrenia and other psychotic disorders: Schizophrenia. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Oct. 30, 2008.
- Dyer JG, et al. Update on early intervention in schizophrenia. Journal of Psychosocial Nursing. 2008;46:19.
- Turkington D, et al. Cognitive behavior therapy for schizophrenia. American Journal of Psychiatry. 2006;163:365.
- Treating schizophrenia. A quick reference guide. Arlington, Va.: American Psychiatric Association. http://www.psychiatryonline.com. Accessed Dec. 9, 2008.
- Schultz SH, et al. Schizophrenia: A review. American Family Physician. 2007;75:1821.
- Fink M, et al. Editorial: Catatonia: Subtype or syndrome in DSM? American Journal of Psychiatry. 2006;163:1876.
- Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 10, 2008.
- Treatment of patients with schizophrenia, 2nd ed. Arlington, Va.: American Psychiatric Association. http://www.psychiatryonline.com. Accessed Dec. 9, 2008.
