Harvard Mental Health Letter

Questions & Answers: How important is early care for schizophrenia?

Q. How important is early care for schizophrenia?

A. Research is beginning to show that it's very important. The condition of people with schizophrenia declines most in the first few years after the diagnosis, and they respond less well to treatment with passing time and repeated psychotic episodes. The first episode of psychosis (hallucinations and delusions) should be treated as soon and as thoroughly as possible. And psychosocial treatment is at least as important as antipsychotic drugs.

Antipsychotic drugs, a mainstay of schizophrenia treatment, are most effective in the first psychotic episode. Half of patients get some relief from the psychotic symptoms within three months and three-quarters within six months. But often they stop taking the drugs because of side effects like weight gain, sedation, and, with the older medications, movement disorders. And even if they continue, some hallucinations and delusions may persist, or they may develop problems with depression, anxiety, or alcohol and drugs. Their risk of suicide is higher than average, and highest early in the course of the illness.

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