Childhoodschizophrenia

Treatment
ByMayoClinicStaff
Schizophreniainchildrenrequireslifelongtreatment,evenduringperiodswhensymptoms
seemtogoaway.Treatmentisaparticularchallengeforchildrenwithschizophrenia.

Treatmentteam
Childhoodschizophreniatreatmentisusuallyguidedbyachildpsychiatristexperiencedin
treatingschizophrenia.Theteamapproachmaybeavailableinclinicswithexpertisein
schizophreniatreatment.Theteammayinclude,forexample,your:

Psychiatrist,psychologistorothertherapist
Psychiatricnurse
Socialworker
Familymembers
Pharmacist
Casemanagertocoordinatecare

Maintreatmentoptions
Themaintreatmentsforchildhoodschizophreniaare:

Medications
Psychotherapy
Lifeskillstraining
Hospitalization

Medications
Mostoftheantipsychoticsusedinchildrenarethesameasthoseusedforadultswith
schizophrenia.Antipsychoticdrugsareofteneffectiveatmanagingsymptomssuchas
delusions,hallucinations,lossofmotivationandlackofemotion.

Ingeneral,thegoaloftreatmentwithantipsychoticsistoeffectivelymanagesymptomsatthe
lowestpossibledose.Overtime,yourchild'sdoctormaytrycombinations,differentmedications
ordifferentdoses.Dependingonthesymptoms,othermedicationsalsomayhelp,suchas
antidepressantsorantianxietydrugs.Itcantakeseveralweeksafterstartingamedicationto
noticeanimprovementinsymptoms.

Secondgenerationantipsychotics
Newer,secondgenerationmedicationsaregenerallypreferredbecausetheyhavefewerside
effectsthandofirstgenerationantipsychotics.However,theycancauseweightgain,highblood
sugar,highcholesterolandheartdisease.

ExamplesofsecondgenerationantipsychoticsapprovedbytheFoodandDrugAdministration
(FDA)totreatschizophreniainteenagersage13andolderinclude:

Aripiprazole(Abilify)
Olanzapine(Zyprexa)
Quetiapine(Seroquel)
Risperidone(Risperdal)

Paliperidone(Invega)isFDAapprovedforchildren12yearsofageandolder.

Firstgenerationantipsychotics
Thesefirstgenerationmedicationsareusuallyaseffectiveassecondgenerationantipsychotics
incontrollingdelusionsandhallucinations.Inadditiontohavingsideeffectssimilartothoseof
secondgenerationantipsychotics,firstgenerationantipsychoticsalsomayhavefrequentand
potentiallysignificantneurologicalsideeffects.Thesecanincludethepossibilityofdevelopinga
movementdisorder(tardivedyskinesia)thatmayormaynotbereversible.

Becauseoftheincreasedriskofserioussideeffectswithfirstgenerationantipsychotics,they
oftenaren'trecommendedforuseinchildrenuntilotheroptionshavebeentriedwithout
success.

ExamplesoffirstgenerationantipsychoticsapprovedbytheFDAtotreatschizophreniain
childrenandteensinclude:

Chlorpromazineforchildren13andolder
Haloperidolforchildren3yearsandolder
Perphenazineforchildren12yearsandolder

Firstgenerationantipsychoticsareoftencheaperthansecondgenerationantipsychotics,
especiallythegenericversions,whichcanbeanimportantconsiderationwhenlongterm
treatmentisnecessary.

Medicationsideeffectsandrisks
Allantipsychoticmedicationshavesideeffectsandpossiblehealthrisks,somelifethreatening.
Sideeffectsinchildrenandteenagersmaynotbethesameasthoseinadults,andsometimes
theymaybemoreserious.Children,especiallyveryyoungchildren,maynothavethecapacity
tounderstandorcommunicateaboutmedicationproblems.

Talktoyourchild'sdoctoraboutpossiblesideeffectsandhowtomanagethem.Bealertfor
problemsinyourchild,andreportsideeffectstothedoctorassoonaspossible.Thedoctor
maybeabletoadjustthedoseorchangemedicationsandlimitsideeffects.

Also,antipsychoticmedicationscanhavedangerousinteractionswithothersubstances.Tell
yourchild'sdoctoraboutallmedicationsandoverthecounterproductsyourchildtakes,
includingvitamins,mineralsandherbalsupplements.

Psychotherapy
Inadditiontomedication,psychotherapy,sometimescalledtalktherapy,canhelpmanage
symptomsandhelpyouandyourchildcopewiththedisorder.Psychotherapymayinclude:

Individualtherapy.Psychotherapy,suchascognitivebehavioraltherapy,withaskilled
mentalhealthprofessionalcanhelpyourchildlearnwaystodealwiththestressanddaily
lifechallengesbroughtonbyschizophrenia.Therapycanhelpreducesymptomsandhelp
yourchildmakefriendsandsucceedatschool.Learningaboutschizophreniacanhelpyour
childunderstandthecondition,copewithsymptomsandsticktoatreatmentplan.
Familytherapy.Yourchildandyourfamilymaybenefitfromtherapythatprovidessupport
andeducationtofamilies.Involved,caringfamilymemberswhounderstandchildhood
schizophreniacanbeextremelyhelpfultochildrenlivingwiththiscondition.Familytherapy
canalsohelpyouandyourfamilytoimprovecommunication,workoutconflictsandcope
withstressrelatedtoyourchild'scondition.

Lifeskillstraining
Treatmentplansthatincludebuildinglifeskillscanhelpyourchildfunctionatageappropriate
levelswhenpossible.Skillstrainingmayinclude:

Socialandacademicskillstraining.Traininginsocialandacademicskillsisanimportant
partoftreatmentforchildhoodschizophrenia.Childrenwithschizophreniaoftenhave
troubledrelationshipsandschoolproblems.Theymayhavedifficultycarryingoutnormal
dailytasks,suchasbathingordressing.
Vocationalrehabilitationandsupportedemployment.Thisfocusesonhelpingpeople
withschizophreniapreparefor,findandkeepjobs.

Hospitalization
Duringcrisisperiodsortimesofseveresymptoms,hospitalizationmaybenecessary.Thiscan
helpensureyourchild'ssafetyandmakesurethatheorsheisgettingpropernutrition,sleep
andhygiene.Sometimesthehospitalsettingisthesafestandbestwaytogetsymptomsunder
controlquickly.

Partialhospitalizationandresidentialcaremaybeoptions,butseveresymptomsareusually
stabilizedinthehospitalbeforemovingtotheselevelsofcare.

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