Treatments and drugs

By Mayo Clinic Staff

Disorganized schizophrenia is a chronic condition that requires lifelong treatment, even during periods when symptoms have lifted. People with this condition may feel as if treatment isn't necessary, and may be tempted to ignore treatment recommendations. But effective treatment can help people with disorganized schizophrenia take control of the condition and enjoy a happier and healthier life.

Treatment options are 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 there may be others on the treatment team, as well, because the condition can affect so many areas of life.

Treatment team members may include:

  • 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
  • Psychotherapy
  • Hospitalization
  • Electroconvulsive therapy (ECT)
  • Vocational skills training

Medications for disorganized schizophrenia

Medications are a key 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 delusions and hallucinations. 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 needed.
  • 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 help symptoms of depression. Anti-anxiety medications improve 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 dose. Which medication is best depends on each person's individual situation. It can take several weeks after starting a medication to notice an improvement in symptoms.

If one medication doesn't work well or has intolerable side effects, the treatment team may recommend combining medications, switching to a different medication or adjusting the dosage.

If your loved one smokes, he or she may need a higher dose of antipsychotic medication because nicotine interferes with these medications. Make sure your loved one's doctors know about his or her smoking habits.

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 a person's white blood cell count or cause health problems in older adults.

If your loved one is being treated for disorganized schizophrenia, talk with the doctor about possible medication side effects and dangerous interactions with other substances. Also be sure to follow the doctor's recommended scheduled for health checkups.

It's not safe to make any changes to mental health medications without talking to a doctor. Psychotic symptoms may relapse if medications are stopped. In addition, antipsychotic medication needs to be tapered off, rather than stopped abruptly, to avoid withdrawal symptoms.

Psychotherapy for disorganized schizophrenia

Although medications are a key disorganized schizophrenia treatment, counseling (psychotherapy) also is essential. Psychotherapy may include:

  • Individual therapy. Psychotherapy with a skilled mental health provider can help teach new ways to cope with the distress and daily life challenges brought on by disorganized schizophrenia. One approach, called cognitive behavioral therapy, has proved to be especially helpful in the treatment of schizophrenia. In cognitive behavioral therapy, a mental health provider helps people with mental health problems recognize — and change — harmful ideas and behaviors. As part of this process, the therapist will help the affected person look back on his or her personal history, looking for insights into when, and why, harmful ideas and behaviors formed. Building from this new understanding, the therapist can help start to change those patterns. Psychotherapy can help reduce the severity of symptoms and improve the affected person's communication skills, relationships, ability to work and motivation to stick to a treatment plan.
  • Family therapy. Family therapy that provides support and education to families may help improve family members' understanding of disorganized schizophrenia, improve family awareness of stressful situations that might trigger a relapse, and increase the affected person's ability to stick with a treatment plan. Family therapy can also help improve communication, reduce conflict and help family members cope.

Hospitalization for disorganized schizophrenia

During crisis periods or times of severe symptoms, hospitalization may be necessary. This can help ensure the safety of the affected person and others, ensure proper nutrition, sleep and hygiene. Partial hospitalization and residential care also may be options.

Electroconvulsive therapy (ECT) for disorganized schizophrenia

Electroconvulsive therapy (ECT) is a procedure in which electric currents are passed through the 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. Because ECT can provide significant improvements in symptoms more quickly than can medications or psychotherapy, electroconvulsive therapy may be the best treatment option in some cases.

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. A therapist can teach skills as good hygiene, cooking and better communication. Many communities have programs that can help with jobs, housing, self-help groups and crisis situations.

If your loved one doesn't have a case manager to help with these services, ask your loved one's doctors about getting one.

Dec. 10, 2010