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Treatments and drugs
By Mayo Clinic staffDisorganized 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
Disorganized 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 disorganized 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 disorganized schizophrenia are:
- Medications
- Hospitalization
- Psychotherapy
- Electroconvulsive therapy (ECT)
- Vocational skills training
Medications for disorganized schizophrenia
Medications are the cornerstone of disorganized schizophrenia treatment. Among the medications most commonly prescribed for disorganized schizophrenia are:
- First-generation (typical) antipsychotics. These medications are thought to control symptoms by affecting brain chemicals called neurotransmitters. These medications have traditionally been very effective in managing such symptoms as hallucinations and delusions. These medications, however, have frequent and potentially severe neurological side effects, including the possibility of tardive dyskinesia, or involuntary jerking movements. Typical antipsychotics, especially generic versions, are often cheaper than are their newer counterparts, which can be an important consideration when long-term treatment is necessary.
- Second-generation (atypical) antipsychotics. These newer antipsychotic medications are effective at managing hallucinations, delusions and other symptoms, such as loss of motivation and lack of emotion. Atypical antipsychotic medications pose a risk of metabolic side effects, including weight gain, diabetes and high cholesterol.
- Other medications. It's common to have other mental health issues along with disorganized schizophrenia. Antidepressants can be helpful if you have symptoms of depression. Anti-anxiety medications can be helpful if you have symptoms of anxiety or agitation. And mood-stabilizing medications may help with aggression or hostility.
Choosing a medication
In general, the goal of treatment with antipsychotic medications is to effectively control signs and symptoms at the lowest possible dosage. Which medication is best for you depends on your individual situation. It can take several weeks after first starting a medication to notice an improvement in your symptoms.
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 symptoms if you stop taking your medication. In addition, antipsychotic medication needs to be tapered off, rather than stopped abruptly, to avoid withdrawal symptoms.
Medication side effects and risks
All antipsychotic medications have side effects and possible health risks. Certain antipsychotic medications may increase the risk of diabetes, weight gain, high cholesterol and high blood pressure, for instance. Others can cause dangerous changes in your white blood cell count or cause health problems in older adults.
Be sure to talk to your doctor about all of the possible side effects and about being routinely checked for health problems while you take these medications. Antipsychotic medications can also have dangerous interactions with other substances. Tell your doctors about all medications and over-the-counter substances you take, including vitamins, minerals and herbal supplements.
Hospitalization for disorganized schizophrenia
During crisis periods or times of severe symptoms, hospitalization may be necessary. This can help ensure your own safety and that of others, and make sure that you're getting proper nutrition, sleep and hygiene. Partial hospitalization and residential care also may be options.
Psychotherapy for disorganized schizophrenia
Although medications are the cornerstone of disorganized 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 disorganized schizophrenia. Therapy can help improve communication skills, your ability to perform routine daily activities, relationships, your ability to work and your motivation to stick to your treatment plan. Learning about disorganized 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 disorganized schizophrenia. There are many types of psychotherapy that may be useful, such as cognitive behavioral therapy.
- 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.
Electroconvulsive therapy (ECT) for disorganized 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 disorganized schizophrenia. ECT may be an option for you if your symptoms are severe or if medications haven't helped. Deciding whether electroconvulsive therapy is a good option for you can be extremely difficult. Make sure you understand all the pros and cons.
Social and vocational skills training for disorganized schizophrenia
Training in social and vocational skills to live independently is an important part of recovery from disorganized 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 disorganized 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 disorganized 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.
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