Treatment for paranoid schizophrenia primarily focuses on managing and relieving the symptoms of paranoid schizophrenia so that the sufferer can function independently and improve the quality of their life.
- Understanding Treatment For Schizophrenia
- When To See A Doctor?
- Treatment For Schizophrenia With Paranoia
- 1. Medications
- 2. Psychotherapy
- A. Cognitive behavioral therapy (CBT)
- B. Cognitive Enhancement Therapy (CET)
- C. Supportive psychotherapy
- D. Group therapy
- E. Social support
- F. Electroconvulsive Therapy (ECT)
- 3. Hospitalization
- 4. Complementary treatments
- Recovery Is Possible
Understanding Treatment For Schizophrenia
Schizophrenia with paranoia is a form of schizophrenia and a disabling mental condition that involves delusions and hallucinations. It can seriously affect a person’s thoughts, feelings, behavior, education, career, relationships, decision making and daily functioning, if left untreated. This is why it is crucial to get early treatment for schizophrenia under licensed and trained doctors or mental health professionals, like psychologists or psychiatrists, after getting diagnosed with the disorder. Developing and following the right medical care plan can enhance likelihood of managing the symptoms and getting better.
Treatment for schizophrenia with paranoia can be a lifelong process. So it is important that the patient and their caregiver have realistic expectations and have patience. Moreover it is also important to continue the treatment once the patient starts feeling better as stopping medications suddenly can lead to relapse or worsen the symptoms. If you or a loved one is affected by paranoid schizophrenia, then consult a medical professional immediately.
When To See A Doctor?
Although paranoid schizophrenia is not considered as a medical diagnosis anymore, a person with schizophrenia can suffer from paranoia 1. To be diagnosed 2, a sufferer must experience delusions, hallucinations, disorganized speech, catatonic behavior or negative symptoms of schizophrenia 3 or at least one of these. Diagnosis should also consider the severity of the symptoms and whether they are leading to impaired daily functioning.
Once diagnosed, treatment for paranoid schizophrenia can be effective with medications and therapy under the guidance of a trained mental health professional. However, as most sufferers do not believe that they have a mental disorder, they are often reluctant to seek medical treatment. But if the patient is at risk of harming themselves or other people around them, then involuntary medical treatment may become mandatory. A reluctant patient may even be legally required to be hospitalized for three to seven days. Treatment is also crucial if the patient is having suicidal thoughts.
Here are some other signs that the patients must seek medical advice and consult a doctor immediately:
- Symptoms tend to be getting worse
- Worsening delusions
- Worsening hallucinations
- Feelings of being controlled by external forces or out of control
- Inability to care for self
- Loved ones are concerned with the patient’s behaviour
- Tendency for self-harm or suicide or to harm others
Treatment For Schizophrenia With Paranoia
As this chronic psychiatric disorder is a lifelong condition, there is no specific cure for paranoid schizophrenia. However, the symptoms can be managed effectively through long-term treatment for schizophrenia involving a combination of different treatment approaches, like therapy and medication. But the symptoms may reappear or get worse if the sufferer refuses to follow the instructions of their doctor or stops suddenly.
Moreover, identifying the best treatment approach may also take some time as it depends on the intensity of the symptoms, frequency of symptoms and the patient’s age. This is why it is important that the patient and their doctor work together to develop the best and most effective treatment plan. In extreme cases, hospitalizations may be required to keep the patient and their loved ones safe.
Here are some available treatment options for paranoid schizophrenia:
The most common type of medications prescribed for the treatment for schizophrenia is antipsychotics. These drugs can relieve major symptoms, like hallucinations and delusions, by regulating dopamine in your brain. Although the medicines can take a number of weeks to show it’s effects on the patient, you may start to feel better within a few days. The medications typically take 3 to 6 weeks or even upto 12 weeks to be fully effective. However, sometimes these may reduce symptoms almost immediately as well. Research 4 have found that in about 7% of patients, these medications prove ineffective, whereas, in 30% of cases, the patients generally do not respond positively to antipsychotic drugs.
Regardless, make sure to follow the instructions of your doctor and follow the treatment plan. If you stop taking your medicines, the symptoms may come back or even get worse. The doctor and the patients may also need to work together to try different combinations of medications to know what medicines and dosage works best for them.
Some common types of first generation or typical antipsychotics used in the treatment for schizophrenia may include:
However, these antipsychotics can have certain side effects, such as –
- Drowsiness and fatigue
- Dizziness and slowness
- Low blood pressure
- Nausea or vomiting
- Extreme weight gain
- Blurred vision
- Dry mouth
- Sexual problems
- Tardive dyskinesia
- Extrapyramidal symptoms, like stiffness or shakiness of muscles & uncontrollable movements
If the side effects are severe, make sure to consult your doctor as they may change or switch the antipsychotics with newer ones, known as second generation (atypical) antipsychotics that have fewer side effects, such as –
- Clozapine (Clozaril)
- Risperidone (Risperdal)
- Asenapine (Saphris)
- Lurasidone (Latuda)
- Aripiprazole (Abilify)
- Ziprasidone (Geodon)
- Paliperidone (Invega)
- Quetiapine (Seroquel)
- Olanzapine (Zyprexa)
- Iloperidone (Fanapt)
Clozapine is the only second-generation antipsychotic medication that has been approved by the U.S. Food and Drug Administration (FDA) for the treatment for schizophrenia with paranoia. It has also shown to reduce suicidal ideation and behavior. However, clozapine can have multiple medical risks. Apart from antipsychotics, a mental health expert or a doctor may prescribe other medications as well, such as antidepressants or anti-anxiety drugs. It is crucial that you avoid consuming nicotine, alcohol, marijuana, street drugs or other substances during your treatment as these can make the medications ineffective. They may also lead to the development of this mental disorder and make the condition worse.
After medications start bringing delusions and hallucinations under control, therapy can be recommended by your doctor or psychiatrist or psychologist as the treatment for schizophrenia. Psychotherapy or counseling can help a person with paranoid schizophrenia to live independently by identifying warning signs, learning stress management techniques and understanding the need for seeking treatment and help. Therapy enables the patient to gain back control of their life, improve their daily functioning ability, focus on self-care, pursue education or career and strengthen personal and social relationships. Therapy can also encourage patients to stick to the treatment plan and take their medications properly.
Some of the most common therapy options for the treatment for schizophrenia include-
- Cognitive behavioural therapy (CBT)
- Cognitive enhancement therapy (CET)
- Supportive psychotherapy
- Coordinated Specialty Care (CSC)
- Vocational training therapy
- Group therapy
- Peer support group
Let’s take a look at some of these available therapy options for paranoid schizophrenia:
A. Cognitive behavioral therapy (CBT)
Cognitive behavioral therapy (CBT) 7 is a well-known type of psychotherapy that shows patients how to manage the difficult symptoms by identifying their thoughts and feelings, especially delusions and hallucinations. According to a 2012 study 8, “CBT seems to offer better results when it is offered at specific stages of recovery and when the treatment delivery is adjusted to the stage.”
CBT can help the sufferer to ignore unreal thoughts and sensations, reduce co-occurring anxiety & depression, cope with past trauma, improve relationships, develop social skills, and support occupational recovery. One 2009 study 9, 6(12), 32–39. )) found that patients “receiving CBT worked more weeks and more hours and had better work performance over the 26-week study compared to those receiving standard vocational support.”
B. Cognitive Enhancement Therapy (CET)
Cognitive Enhancement Therapy (CET) is another helpful option for the treatment for schizophrenia as it can significantly improve cognitive functioning and enhance the patient’s belief in their cognitive abilities. It incorporates a combination of computer-based brain training & group sessions to relieve the symptoms. A 2009 study 10 reveals “CET appears to be an effective approach to the remediation of cognitive deficits in early schizophrenia that may help reduce disability among this population.”
C. Supportive psychotherapy
This form of psychotherapy or counseling is used to enable the patient to process their own thoughts, feelings and experience and to support them in dealing and living with this condition. The therapy technique is designed to focus more on mindfulness and here & now rather than on adverse childhood experiences or trauma.
D. Group therapy
Group therapy can also be helpful as the person can interact and learn from other individuals who are having similar experiences. It also helps to reduce feelings of isolation and loneliness by building a sense of community among people with this disorder.
E. Social support
Love, support and encouragement from family and friends is also crucial for the recovery process. Social support can increase the likelihood of successful recovery, improve communication skills, find and hold jobs and enhance their overall wellbeing.
F. Electroconvulsive Therapy (ECT)
A doctor may also recommend ECT as a treatment for schizophrenia in severe cases. Electroconvulsive therapy is primarily used for curing severe depression and suicidal tendencies. It is regarded as one of the most effective treatments for people with psychosis, catatonia, mania or other mental illnesses, like schizophrenia. The process involves sending controlled electric currents through the brain to cause a brief seizure and “reboot” the brain. According to a 2011 study 11, ECT can be helpful in the treatment for schizophrenia as it can “augment the effect of antipsychotics and the most common target symptom was catatonia.”
In case the medications and therapy prove ineffective in managing delusions & hallucinations and in the treatment for schizophrenia, hospitalization may be recommended by a doctor. Moreover, if the symptoms become too severe and the patient is at risk of harming themselves or others, then immediate medical attention may be required. Hospitalization may also be suggested for individuals who are unable to care for themselves or have basic necessities, like food, clothing and shelter.
A patient can also be hospitalized voluntarily, if they recognize their symptoms are getting out of control. However, a mental health professional or a doctor may be legally obliged to hospitalize a patient they deem fit, even when the patient is unwilling to seek treatment. In such cases, the patient may be involuntarily admitted for medical evaluation for 3 to 7 days. If there is a need to extend the involuntary hospitalization, then a court order may be required.
4. Complementary treatments
There are different alternative treatments available for coping with paranoid schizophrenia that can help a person to recover, when used along with medications and psychotherapy. However, It is important that the sufferer and family members discuss such complementary treatment for schizophrenia with the doctor before going forward. One 2018 study 12 states, “In addition to conventional pharmacological therapy, it is important to include other non-pharmacological interventions to assist the patients to obtain financial management, independent community living, independent living skill, insurance needs, public trustee and guardianship, relationship, friendship, and entertainment as well as manage alcohol and other drug issues, domestic violence, and any other health problems issues.”
Here are some complementary medicines that can be recommended to schizophrenia patients:
- Tai chi
- Exercise (aerobic and anaerobic)
- Nutritional interventions
- Equine-assisted psychotherapy (EAP)
Following a balanced nutritional diet can substantially help in curing the condition as Omega-3 fatty acids, usually found in fish oil, can greatly help to manage the symptoms. Moreover, Equine therapy, a type of animal-assisted therapy, can make sufferers to care for a horse which tends to improve their behavioural and emotional outcomes. However, it should be noted that complementary treatments are not a substitute for traditional medical treatment for schizophrenia with paranoia under the guidance of a licensed and experienced doctor.
Recovery Is Possible
Apart from following the treatment plan, taking medicines as prescribed by the doctor, and going for regular check-ups, the patients can use certain self-help techniques, like seeking support from friends and family, joining a support group, following a healthy lifestyle and socializing, to increase their chances for recovery. Although the condition may last a lifetime, early and effective treatment for schizophrenia with paranoia can help the sufferer to overcome the symptoms and live a healthier, more independent life.References:
- Pinkham AE, Harvey PD, Penn DL. PARANOID INDIVIDUALS WITH SCHIZOPHRENIA SHOW GREATER SOCIAL COGNITIVE BIAS AND WORSE SOCIAL FUNCTIONING THAN NON-PARANOID INDIVIDUALS WITH SCHIZOPHRENIA. Schizophr Res Cogn. 2016 Mar;3:33-38. doi: 10.1016/j.scog.2015.11.002. Epub 2016 Jan 13. PMID: 27990352; PMCID: PMC5156478.
- Rahman, T., & Lauriello, J. (2016). Schizophrenia: An Overview. Focus (American Psychiatric Publishing), 14(3), 300–307. https://doi.org/10.1176/appi.focus.20160006
- Mitra, S., Mahintamani, T., Kavoor, A. R., & Nizamie, S. H. (2016). Negative symptoms in schizophrenia. Industrial psychiatry journal, 25(2), 135–144. https://doi.org/10.4103/ipj.ipj_30_15
- Hany M, Rehman B, Azhar Y, et al. Schizophrenia. [Updated 2020 Dec 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539864/
- Rask PH, Krarup G, Kragh-Sørensen P, Andersen E, Brøsen K, Gerholt F, Glue P, Hørder M, Kjeldsen CS, Klitgaard NA, et al. Terapistyring af perfenazinbehandling ved paranoide tilstande. 1. Organisatoriske aspekter [Therapy control of perphenazine in paranoid conditions. 1. Organizational aspects]. Ugeskr Laeger. 1991 Aug 19;153(34):2336-9. Danish. PMID: 1897042.
- Ostinelli, E. G., Brooke-Powney, M. J., Li, X., & Adams, C. E. (2017). Haloperidol for psychosis-induced aggression or agitation (rapid tranquillisation). The Cochrane database of systematic reviews, 7(7), CD009377. https://doi.org/10.1002/14651858.CD009377.pub3
- Rector, N., & Beck, A. (2012). Cognitive Behavioral Therapy for Schizophrenia: An Empirical Review Neil A. Rector, PhD and Aaron T. Beck, MD (2001). Reprinted from the J Nerv Ment Dis 189:278–287. The Journal of Nervous and Mental Disease, 200, 832–839.
- Addington, J., & Lecomte, T. (2012). Cognitive behaviour therapy for schizophrenia. F1000 medicine reports, 4, 6. https://doi.org/10.3410/M4-6
- Morrison A. K. (2009). Cognitive behavior therapy for people with schizophrenia. Psychiatry (Edgmont (Pa. : Township
- Eack, S. M., Greenwald, D. P., Hogarty, S. S., Cooley, S. J., DiBarry, A. L., Montrose, D. M., & Keshavan, M. S. (2009). Cognitive enhancement therapy for early-course schizophrenia: effects of a two-year randomized controlled trial. Psychiatric services (Washington, D.C.), 60(11), 1468–1476. https://doi.org/10.1176/appi.ps.60.11.1468
- Phutane, V. H., Thirthalli, J., Kesavan, M., Kumar, N. C., & Gangadhar, B. N. (2011). Why do we prescribe ECT to schizophrenia patients?. Indian journal of psychiatry, 53(2), 149–151. https://doi.org/10.4103/0019-5545.82544
- Ganguly, P., Soliman, A., & Moustafa, A. A. (2018). Holistic Management of Schizophrenia Symptoms Using Pharmacological and Non-pharmacological Treatment. Frontiers in public health, 6, 166. https://doi.org/10.3389/fpubh.2018.00166