Treatments and drugsBy Mayo Clinic staff
Childhood schizophrenia is a chronic condition, lasting through adulthood. Because of this, schizophrenia in children requires lifelong treatment, even during periods when symptoms seem to have subsided. Treatment is similar for all types of schizophrenia, but is a particular challenge for children with schizophrenia.
Childhood schizophrenia treatment is usually guided by a psychiatrist skilled in treating schizophrenia in children. But because the condition can affect so many areas of your child's life, other professionals may be on the treatment team too. The treatment team can help make sure that your child is getting all of the treatment he or she needs and that care is coordinated among all of his or her care providers.
The team involved in treatment of childhood schizophrenia may include your:
- Pediatrician or family doctor
- Case worker
- Psychiatric nurse
- Social worker
- Family members
Main treatment options
The main treatments for childhood schizophrenia are:
- Individual and family psychotherapy
- Social and academic skills training
Medications for childhood schizophrenia
Antipsychotic medications are at the heart of treatment for schizophrenia in children. Most of the medications used in children are the same as those used to treat adults with schizophrenia. While most of those medications haven't been specifically approved to treat children — mainly because they haven't been thoroughly tested in children — they can be used off-label in children. Off-label use is a common and legal practice of using a medication to treat a condition or age group not specifically listed on its prescribing label as an approved use.
Because of the possibility of serious side effects, make sure you understand all the pros and cons of antipsychotic medication use in children.
Second-generation antipsychotics (atypical antipsychotics)
A class of antipsychotic medications called atypical antipsychotic medications are usually tried first in children because they have fewer side effects. The Food and Drug Administration has approved only two second-generation antipsychotics to treat childhood schizophrenia in children ages 13 to 17:
- Risperidone (Risperdal)
- Aripiprazole (Abilify)
Atypical antipsychotic medications are often effective at managing such symptoms as hallucinations, delusions, loss of motivation and lack of emotion. Serious side effects can include weight gain, diabetes and high cholesterol and, more rarely, movement disorders.
First-generation antipsychotics (conventional, or typical, antipsychotics)
These antipsychotic medications are usually equally as effective as second-generation antipsychotics in controlling delusions and hallucinations. Conventional antipsychotics, however, may have more serious neurological side effects. Risks include the possibility of developing a movement disorder (tardive dyskinesia) that causes involuntary movements of the face, tongue, limbs and hands. Although the conventional and atypical antipsychotics both share this risk, the conventional agents are more likely to result in movement disorders, especially if they are taken over a long period of time.
Typical antipsychotics, especially generic versions, are often cheaper than second-generation antipsychotics. However, their risk of serious side effects means they often aren't recommended for use in children until other options have been tried without success.
Medication side effects and risks
All antipsychotic medications have side effects and possible health risks, some life-threatening. Side effects in children and adolescents may not be the same as those in adults, and sometimes they may be more serious. Children, especially very young children, may not have the capacity to understand or communicate about medication problems.
Be sure to talk to your child's doctors about all of the possible side effects and about routine checks for health problems while he or she takes these medications. Also, be alert for problems in your child, and report side effects to the doctor as soon as possible. By spotting medication problems early, your child's doctor may be able to adjust the dosage or change medications and limit side effects. Your child's doctors also can help all of you learn to manage side effects appropriately.
Also, antipsychotic medications can have dangerous interactions with other substances. Tell your child's doctors about all medications and over-the-counter substances he or she takes, including vitamins, minerals and herbal supplements.
Psychotherapy for childhood schizophrenia
Although medications are a key childhood schizophrenia treatment, psychotherapy also is important. Psychotherapy may include:
- Individual therapy. Psychotherapy with a skilled mental health provider can help your child learn ways to cope with the stress and daily life challenges brought on by schizophrenia. Therapy can help reduce symptoms and can help your child make friends and succeed at school. Learning about childhood schizophrenia can help your child understand his or her condition, cope with symptoms, and stick to a treatment plan. There are many types of psychotherapy that may be useful, such as cognitive behavioral therapy.
- Family therapy. Both your child and your family may benefit from therapy that provides support and education to families. Involved, caring family members who understand childhood schizophrenia can be extremely helpful to children living with this condition. Family therapy can also help you and your family communicate better with each other, work out conflicts and cope with stress related to your child's condition.
Social and academic skills training for childhood schizophrenia
Training in social and academic skills is an important part of treatment for childhood schizophrenia. Children with schizophrenia often have troubled relationships and school problems. They may have difficulty carrying out normal daily tasks, such as bathing or dressing. Treatment plans that include skill-building in these areas can help your child function at age-appropriate levels when possible.
Hospitalization for childhood schizophrenia
During crisis periods or times of severe symptoms, hospitalization may be necessary. This can help ensure your child's safety and that of others, and make sure that he or she is getting proper nutrition, sleep and hygiene. Getting symptoms under control quickly is very important in childhood schizophrenia, and sometimes the hospital setting is the safest and best way to do this. Partial hospitalization and residential care also may be options, but symptoms are usually more stabilized before moving to these levels of care.
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