If people with schizophrenia become depressed, it may be necessary to add an antidepressant to their drug regimen.

Length of treatment. Like diabetes or high blood pressure, schizophrenia is a chronic disorder that needs constant management. At the moment, it cannot be cured but the rate or recurrence of psychotic episodes can be decreased significantly by staying on medication. Although responses vary from person to person, most people with schizophrenia need to take some type of medication for the rest of their lives and use other approaches, such as supportive therapy or rehabilitation, as well.

Relapses occur most often when people with schizophrenia stop taking their antipsychotic medication because they feel better, or only take it occasionally because they forget or don’t think taking it regularly is important. It is very important for people with schizophrenia to take their medication on a regular basis and for as long as their doctors recommend. If they do so, they will experience fewer psychotic symptoms.

There are a variety of reasons why people with schizophrenia do not adhere to treatment. If they don’t believe they are ill, they may not think they need medication at all. If their thinking is too disorganized, they may not remember to take their medication every day. If they don’t like the side effects of one medication, they may stop taking it without trying a different medication. Substance abuse can also interfere with treatment effectiveness. Physicians should ask patients how often they take their medication and be sensitive to a patient’s request to change dosages or to try new medications in order to eliminate unwelcome side effects.

Medication interaction. Antipsychotic medications can produce unpleasant or dangerous side effects when taken with certain other drugs. For this reason, the doctor who prescribes the antipsychotics should be told about all medications (over-the-counter and prescription) and all vitamins, minerals, and herbal supplements the patient takes. Alcohol or other drug use should also be discussed.

Psychosocial treatment. Numerous studies have found that psychosocial treatments can help patients deal with certain aspects of schizophrenia, such as difficulty with communication, motivation, self-care, work, and establishing and maintaining relationships with others.

Getting treatment. People with schizophrenia often resist treatment, believing that their delusions or hallucinations are real and psychiatric help is not required. If a crisis occurs, family and friends can help.

People with mental illnesses who do not want treatment may hide their strange behavior or ideas from a professional, so family members and friends should ask to speak privately with the person conducting the patient’s examination and explain what has been happening at home. The professional will then be able to question the patient and hear the patient’s distorted thinking for themselves. Professionals must personally witness bizarre behavior and hear delusional thoughts before they can legally recommend commitment, and family and friends can give them the information they need to do so.

Caregiving. Ensuring that people with schizophrenia continue to get treatment and take their medication after they leave the hospital is also important. If patients stop taking their medication or stop going for follow-up appointments, their psychotic symptoms will return. If these symptoms become severe enough, they can become unable to care for their own basic needs for food, clothing, and shelter; neglect personal hygiene; and end up on the street or in jail, where they rarely receive the kind of help they need.

Family and friends can also help patients set realistic goals and regain their ability to function in the world. Each step towards these goals should be small enough to be attainable, and the patient should pursue them in an atmosphere of support. People with a mental illness who are pressured and criticized usually regress and their symptoms worsen. Telling them what they are doing right is the best way to help them move forward.

What is the outlook for the future? The outlook for people with schizophrenia has improved over the last 30 years or so. Although we still do not have a cure, effective treatments have been developed, and many people with schizophrenia improve enough to lead independent, satisfying lives.

This is a very exciting time for schizophrenia research. The explosion of knowledge in genetics, neuroscience, and behavioral research are all being used to understand the causes of the disorder, how to prevent it, and how to develop better treatments to allow those with schizophrenia achieve their full potential.