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Schizophrenia

Schizophrenia · Schizofrenie

What it is

A disorder of dopamine signalling and cortical connectivity affecting ~1%.

Symptoms & signs

  • Hallucinations
  • delusions
  • disorganised speech
  • flat affect
  • social withdrawal
  • cognitive decline

🚩 Get help if…

  • call 112 / 911 now Voices telling you to harm yourself or others
  • call 112 / 911 now Thoughts of suicide
  • call 112 / 911 now Fever, rigid muscles and confusion on antipsychotics
  • see a doctor soon Stopping medicines, less sleep or growing suspicion — early relapse

Where it strikes

Medical treatment

  • Antipsychotics — they clearly prevent relapse, at the cost of weight, diabetes and movement side effects trials support
  • Clozapine when others fail — the most effective, and it needs blood counts for agranulocytosis trials support
  • Long-acting injections — fewer relapses in trials, contested in practice mixed evidence
  • Family therapy trials support
  • Supported employment trials support
  • Xanomeline–trospium (Cobenfy), a muscarinic drug — US-approved 2024

Natural & lifestyle

  • Early intervention services
  • exercise
  • smoking cessation support
  • metabolic monitoring
  • sleep

Emerging & experimental

  • CBT for psychosis
  • cannabidiol adjunct
  • TMS for hallucinations

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Sarcosine and glycine — small trials help negative symptoms early / small studies
  • Anti-inflammatory add-ons (aspirin, minocycline) — small trials disagree mixed evidence
  • Omega-3 to prevent psychosis in high-risk youth — the first trial was positive, a larger one was not not confirmed in trials

ICD codes