Table of ContentsView AllTable of ContentsWhat Is Psychosis and Psychotic Conditions?Therapy for Psychotic DisordersMedications for Psychotic DisordersCAM & OTC MedicationsHow to Make Treatment Effective
Table of ContentsView All
View All
Table of Contents
What Is Psychosis and Psychotic Conditions?
Therapy for Psychotic Disorders
Medications for Psychotic Disorders
CAM & OTC Medications
How to Make Treatment Effective
Close
Psychosis can be a symptom of several mental health conditions. It’s a lot more common than people often think—according to the National Institute of Mental Health, it affects about 100 out of every 100,000 people each year.But that doesn’t mean it isn’t an intense and sometimes frightening experience. Fortunately, it’s also something that is treatable with the right combination of therapy, medication, and support.
At a GlancePsychosis causes delusions and hallucinations that make it hard to distinguish between what’s real and what isn’t. It can happen due to conditions like schizophrenia, bipolar disorder, and depression, and can lead to serious risks. That’s why getting treatment is so important. Psychotic therapy typically involves psychotherapy (like the classic CBT or other approaches like individualized resiliency training) as well as antipsychotic medications. If you’ve experienced psychosis, sticking with your doctor-approved treatment plan is the best way to protect your well-being and prevent future psychotic episodes.
At a Glance
Psychosis causes delusions and hallucinations that make it hard to distinguish between what’s real and what isn’t. It can happen due to conditions like schizophrenia, bipolar disorder, and depression, and can lead to serious risks. That’s why getting treatment is so important. Psychotic therapy typically involves psychotherapy (like the classic CBT or other approaches like individualized resiliency training) as well as antipsychotic medications. If you’ve experienced psychosis, sticking with your doctor-approved treatment plan is the best way to protect your well-being and prevent future psychotic episodes.
Psychosis is a symptom of other disorders, such as schizophrenia, bipolar disorder, and even, sometimes,depression. It can be frightening to those experiencing it and their loved ones, but treatment options do exist. However, without treatment, psychosis can be incredibly dangerous due to the loss of touch with reality.
Treatment usually includes a combination of psychotherapy, case management, and medication. Typically, antipsychotic medications are the medications of choice, sometimes combined with mood stabilizers or antidepressants.
Types of Psychosis
Often, many psychosocial (the combination of psychological factors and their intersection with social factors) methods are used when treating psychosis since it can be very overwhelming to both an individual going through it and their loved ones.
Cognitive-Behavioral Therapy
Cognitive-behavioral therapy(CBT) is most often used in the treatment of psychosis. In fact, there is a specific protocol known as cognitive-behavioral therapy for psychosis (CBTp).
Key tenets of this protocol are learning how to understand the psychotic symptoms, normalizing the experience to reducestigma, and accepting the symptoms to reduce the distress resisting their causes.
Individualized Resiliency Training (IRT)
IRT is another modality specifically designed for those dealing with a recent psychotic episode. It is part of the Navigate Program, an early treatment program for those experiencing psychosis.
IRT contains 14 modules on topics such as relapse prevention planning, developingresilience, and improving social functioning.Therapy typically lasts somewhere between six and 24 months.
Other Therapies
Here is a list of other therapies that may be used to treat psychosis:
Treatment of psychosis and psychotic disorders associated with it is usually grouped into acute treatment and longer-term treatment and is a combination of medication and therapeutic elements.
Acute Phase
Acute agitation can be managed with an antipsychotic, either with or without a benzodiazepine. There are a variety of options available, but one such combination is the antipsychotic Haldol (halperidol) and the benzodiazepineAtivan(lorazepam), which is considered highly effective.Thorazine(chlorpromazine) may also be used.
Generally, antipsychotics are preferred for patients who are known to have psychosis, but there is no specific “gold standard” to manage this, so the types that are used vary widely among individual providers and hospital systems.
Long-Term Treatment
For ongoing treatment, there are several options—first-generation antipsychotics,second-generation antipsychoticsand long-acting injections. Typically, second-generation antipsychotics are newer medications with fewer side effects than first-generation ones.
Second-generation antipsychotics includeRisperdal(risperidone) andClozaril(clozapine). While Clozaril is generally superior to other antipsychotics for treatment-resistant schizophrenia, substance use, aggression, and more, it is less utilized in the United States due to the bloodwork monitoring involved.
Many treatment guidelines suggest that maintenance treatment lasts for up to five years.There’s a higher risk of relapse if medication is discontinued.
Side Effects of Medications
Like many medications, antipsychotic medications do carry a risk of certain side effects that you and your doctor will want to weigh before you choose one.
Some side effects from first-generation antipsychotic medications may include:
Side effects from second-generation antipsychotics may include:
A lot of research and attention is paid to addressing antipsychotic side effects, and many of them can be managed to improve the quality of life for patients with schizophrenia.
Extrapyramidal Side Effects From Medication
Complementary Alternative Medicine & Over-the-Counter Medications
While medication is almost always indicated when someone is dealing with psychosis, certain treatments are effective alongside pharmacological treatment, including exercise and diet.
Below are some complementary alternative medicines (CAM) and over-the-counter (OTC) medications that can be used in the treatment of psychosis:
The Mental Health Benefits of Physical Exercise
How to Make Your Treatment Most Effective
Your treatment may sound daunting to you or you might be afraid it won’t work, but taking small steps can lead to you feeling better.
The Benefits of Meditation for Stress Management
Takeaway
Psychosis may be scary to deal with—either for the one experiencing it or for their loved ones—but there are many treatments for it. The earlier you seek medical attention for symptoms of psychosis, the better your prognosis will be.
What Living With a Psychotic Disorder Feels Like, As a Mental Health Professional
18 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Mental Health.Understanding psychosis.Mehl S, Werner D, Lincoln TM.Does Cognitive Behavior Therapy for Psychosis (CBTP) show a sustainable effect on delusions? A meta-analysis.Front Psychol. 2015;0. doi:10.3389/fpsyg.2015.01450Mueser KT, Penn DL, Addington J, et al.The navigate program for first-episode psychosis: rationale, overview, and description of psychosocial components.PS. 2015;66(7):680-690. doi:10.1176/appi.ps.201400413Hardy K, Meyer-Kalos P, Adams C, Elliott-Remes R, Gingerich S.Brief report describing the integration of two psychotherapy evidence-based practices within coordinated specialty care services for early psychosis.Psychological Services. 2021;18(2):164-169. doi:10.1037/ser0000443van Dam M, van Weeghel J, Stiekema A, Castelein S, Pijnenborg M, van der Meer L.Barriers and facilitators to implementation of cognitive adaptation training in long-term inpatient facilities for people diagnosed with severe mental illness: A nursing perspective.J Psychiatr Ment Health Nurs. 2022;29(4):568-577. doi:10.1111/jpm.12821Manseau M, Bogenschutz M.Substance use disorders and schizophrenia.Focus (Am Psychiatr Publ). 2016;14(3):333-342. doi:10.1176/appi.focus.20160008Patel R, Chan KMY, Palmer EOC, et al.Associations of comorbid substance use disorders with clinical outcomes in schizophrenia using electronic health record data.Schizophrenia Research. 2023;260:191-197. doi:10.1016/j.schres.2023.08.023Biagianti B, Quraishi SH, Schlosser DA.Potential benefits of incorporating peer-to-peer interactions into digital interventions for psychotic disorders: A systematic review.Psychiatr Serv. 2018;69(4):377-388. doi:10.1176/appi.ps.201700283Amore M, D’Andrea M, Fagiolini A.Treatment of agitation with lorazepam in clinical practice: A systematic review.Front Psychiatry. 2021;12:628965. doi:10.3389/fpsyt.2021.628965Zareifopoulos N, Panayiotakopoulos G.Treatment options for acute agitation in psychiatric patients: Theoretical and empirical evidence.Cureus.2019.doi:10.7759/cureus.6152Gammon D, Cheng C, Volkovinskaia A, Baker GB, Dursun SM.Clozapine: Why is it so uniquely effective in the treatment of a range of neuropsychiatric disorders?Biomolecules. 2021;11(7):1030. doi:10.3390/biom11071030Tiihonen J, Tanskanen A, Taipale H.20-year nationwide follow-up study on discontinuation of antipsychotic treatment in first-episode schizophrenia.AJP. 2018;175(8):765-773. doi:10.1176/appi.ajp.2018.17091001Stroup TS, Gray N.Management of common adverse effects of antipsychotic medications.World Psychiatry.2018;17(3):341-356. doi:10.1002/wps.20567Francis M.Cortical activation and cognitive performance during repetitive transcranial magnetic stimulation in first-episode psychosis: A pilot study.clinicaltrials.gov; 2019. https://clinicaltrials.gov/ct2/show/NCT02131129Craig TK, Rus-Calafell M, Ward T, et al.AVATAR therapy for auditory verbal hallucinations in people with psychosis: a single-blind, randomised controlled trial.The Lancet Psychiatry. 2018;5(1):31-40. doi:10.1016/S2215-0366(17)30427-3Sistig B, Lambrecht I, Friedman SH.Journey back into body and soul – An exploration of mindful yoga with psychosis.Psychosis. 2015;7(1):25-36. doi:10.1080/17522439.2014.885556Gaughran F, Stringer D, Berk M, et al.Vitamin D supplementation compared to placebo in people with First Episode psychosis - Neuroprotection Design (Dfend): a protocol for a randomised, double-blind, placebo-controlled, parallel-group trial.Trials. 2020;21(1):14. doi:10.1186/s13063-019-3758-9Cha HY, Yang SJ.Anti-inflammatory diets and schizophrenia.Clin Nutr Res. 2020;9(4):241-257. doi:10.7762/cnr.2020.9.4.241
18 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Mental Health.Understanding psychosis.Mehl S, Werner D, Lincoln TM.Does Cognitive Behavior Therapy for Psychosis (CBTP) show a sustainable effect on delusions? A meta-analysis.Front Psychol. 2015;0. doi:10.3389/fpsyg.2015.01450Mueser KT, Penn DL, Addington J, et al.The navigate program for first-episode psychosis: rationale, overview, and description of psychosocial components.PS. 2015;66(7):680-690. doi:10.1176/appi.ps.201400413Hardy K, Meyer-Kalos P, Adams C, Elliott-Remes R, Gingerich S.Brief report describing the integration of two psychotherapy evidence-based practices within coordinated specialty care services for early psychosis.Psychological Services. 2021;18(2):164-169. doi:10.1037/ser0000443van Dam M, van Weeghel J, Stiekema A, Castelein S, Pijnenborg M, van der Meer L.Barriers and facilitators to implementation of cognitive adaptation training in long-term inpatient facilities for people diagnosed with severe mental illness: A nursing perspective.J Psychiatr Ment Health Nurs. 2022;29(4):568-577. doi:10.1111/jpm.12821Manseau M, Bogenschutz M.Substance use disorders and schizophrenia.Focus (Am Psychiatr Publ). 2016;14(3):333-342. doi:10.1176/appi.focus.20160008Patel R, Chan KMY, Palmer EOC, et al.Associations of comorbid substance use disorders with clinical outcomes in schizophrenia using electronic health record data.Schizophrenia Research. 2023;260:191-197. doi:10.1016/j.schres.2023.08.023Biagianti B, Quraishi SH, Schlosser DA.Potential benefits of incorporating peer-to-peer interactions into digital interventions for psychotic disorders: A systematic review.Psychiatr Serv. 2018;69(4):377-388. doi:10.1176/appi.ps.201700283Amore M, D’Andrea M, Fagiolini A.Treatment of agitation with lorazepam in clinical practice: A systematic review.Front Psychiatry. 2021;12:628965. doi:10.3389/fpsyt.2021.628965Zareifopoulos N, Panayiotakopoulos G.Treatment options for acute agitation in psychiatric patients: Theoretical and empirical evidence.Cureus.2019.doi:10.7759/cureus.6152Gammon D, Cheng C, Volkovinskaia A, Baker GB, Dursun SM.Clozapine: Why is it so uniquely effective in the treatment of a range of neuropsychiatric disorders?Biomolecules. 2021;11(7):1030. doi:10.3390/biom11071030Tiihonen J, Tanskanen A, Taipale H.20-year nationwide follow-up study on discontinuation of antipsychotic treatment in first-episode schizophrenia.AJP. 2018;175(8):765-773. doi:10.1176/appi.ajp.2018.17091001Stroup TS, Gray N.Management of common adverse effects of antipsychotic medications.World Psychiatry.2018;17(3):341-356. doi:10.1002/wps.20567Francis M.Cortical activation and cognitive performance during repetitive transcranial magnetic stimulation in first-episode psychosis: A pilot study.clinicaltrials.gov; 2019. https://clinicaltrials.gov/ct2/show/NCT02131129Craig TK, Rus-Calafell M, Ward T, et al.AVATAR therapy for auditory verbal hallucinations in people with psychosis: a single-blind, randomised controlled trial.The Lancet Psychiatry. 2018;5(1):31-40. doi:10.1016/S2215-0366(17)30427-3Sistig B, Lambrecht I, Friedman SH.Journey back into body and soul – An exploration of mindful yoga with psychosis.Psychosis. 2015;7(1):25-36. doi:10.1080/17522439.2014.885556Gaughran F, Stringer D, Berk M, et al.Vitamin D supplementation compared to placebo in people with First Episode psychosis - Neuroprotection Design (Dfend): a protocol for a randomised, double-blind, placebo-controlled, parallel-group trial.Trials. 2020;21(1):14. doi:10.1186/s13063-019-3758-9Cha HY, Yang SJ.Anti-inflammatory diets and schizophrenia.Clin Nutr Res. 2020;9(4):241-257. doi:10.7762/cnr.2020.9.4.241
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute of Mental Health.Understanding psychosis.Mehl S, Werner D, Lincoln TM.Does Cognitive Behavior Therapy for Psychosis (CBTP) show a sustainable effect on delusions? A meta-analysis.Front Psychol. 2015;0. doi:10.3389/fpsyg.2015.01450Mueser KT, Penn DL, Addington J, et al.The navigate program for first-episode psychosis: rationale, overview, and description of psychosocial components.PS. 2015;66(7):680-690. doi:10.1176/appi.ps.201400413Hardy K, Meyer-Kalos P, Adams C, Elliott-Remes R, Gingerich S.Brief report describing the integration of two psychotherapy evidence-based practices within coordinated specialty care services for early psychosis.Psychological Services. 2021;18(2):164-169. doi:10.1037/ser0000443van Dam M, van Weeghel J, Stiekema A, Castelein S, Pijnenborg M, van der Meer L.Barriers and facilitators to implementation of cognitive adaptation training in long-term inpatient facilities for people diagnosed with severe mental illness: A nursing perspective.J Psychiatr Ment Health Nurs. 2022;29(4):568-577. doi:10.1111/jpm.12821Manseau M, Bogenschutz M.Substance use disorders and schizophrenia.Focus (Am Psychiatr Publ). 2016;14(3):333-342. doi:10.1176/appi.focus.20160008Patel R, Chan KMY, Palmer EOC, et al.Associations of comorbid substance use disorders with clinical outcomes in schizophrenia using electronic health record data.Schizophrenia Research. 2023;260:191-197. doi:10.1016/j.schres.2023.08.023Biagianti B, Quraishi SH, Schlosser DA.Potential benefits of incorporating peer-to-peer interactions into digital interventions for psychotic disorders: A systematic review.Psychiatr Serv. 2018;69(4):377-388. doi:10.1176/appi.ps.201700283Amore M, D’Andrea M, Fagiolini A.Treatment of agitation with lorazepam in clinical practice: A systematic review.Front Psychiatry. 2021;12:628965. doi:10.3389/fpsyt.2021.628965Zareifopoulos N, Panayiotakopoulos G.Treatment options for acute agitation in psychiatric patients: Theoretical and empirical evidence.Cureus.2019.doi:10.7759/cureus.6152Gammon D, Cheng C, Volkovinskaia A, Baker GB, Dursun SM.Clozapine: Why is it so uniquely effective in the treatment of a range of neuropsychiatric disorders?Biomolecules. 2021;11(7):1030. doi:10.3390/biom11071030Tiihonen J, Tanskanen A, Taipale H.20-year nationwide follow-up study on discontinuation of antipsychotic treatment in first-episode schizophrenia.AJP. 2018;175(8):765-773. doi:10.1176/appi.ajp.2018.17091001Stroup TS, Gray N.Management of common adverse effects of antipsychotic medications.World Psychiatry.2018;17(3):341-356. doi:10.1002/wps.20567Francis M.Cortical activation and cognitive performance during repetitive transcranial magnetic stimulation in first-episode psychosis: A pilot study.clinicaltrials.gov; 2019. https://clinicaltrials.gov/ct2/show/NCT02131129Craig TK, Rus-Calafell M, Ward T, et al.AVATAR therapy for auditory verbal hallucinations in people with psychosis: a single-blind, randomised controlled trial.The Lancet Psychiatry. 2018;5(1):31-40. doi:10.1016/S2215-0366(17)30427-3Sistig B, Lambrecht I, Friedman SH.Journey back into body and soul – An exploration of mindful yoga with psychosis.Psychosis. 2015;7(1):25-36. doi:10.1080/17522439.2014.885556Gaughran F, Stringer D, Berk M, et al.Vitamin D supplementation compared to placebo in people with First Episode psychosis - Neuroprotection Design (Dfend): a protocol for a randomised, double-blind, placebo-controlled, parallel-group trial.Trials. 2020;21(1):14. doi:10.1186/s13063-019-3758-9Cha HY, Yang SJ.Anti-inflammatory diets and schizophrenia.Clin Nutr Res. 2020;9(4):241-257. doi:10.7762/cnr.2020.9.4.241
National Institute of Mental Health.Understanding psychosis.
Mehl S, Werner D, Lincoln TM.Does Cognitive Behavior Therapy for Psychosis (CBTP) show a sustainable effect on delusions? A meta-analysis.Front Psychol. 2015;0. doi:10.3389/fpsyg.2015.01450
Mueser KT, Penn DL, Addington J, et al.The navigate program for first-episode psychosis: rationale, overview, and description of psychosocial components.PS. 2015;66(7):680-690. doi:10.1176/appi.ps.201400413
Hardy K, Meyer-Kalos P, Adams C, Elliott-Remes R, Gingerich S.Brief report describing the integration of two psychotherapy evidence-based practices within coordinated specialty care services for early psychosis.Psychological Services. 2021;18(2):164-169. doi:10.1037/ser0000443
van Dam M, van Weeghel J, Stiekema A, Castelein S, Pijnenborg M, van der Meer L.Barriers and facilitators to implementation of cognitive adaptation training in long-term inpatient facilities for people diagnosed with severe mental illness: A nursing perspective.J Psychiatr Ment Health Nurs. 2022;29(4):568-577. doi:10.1111/jpm.12821
Manseau M, Bogenschutz M.Substance use disorders and schizophrenia.Focus (Am Psychiatr Publ). 2016;14(3):333-342. doi:10.1176/appi.focus.20160008
Patel R, Chan KMY, Palmer EOC, et al.Associations of comorbid substance use disorders with clinical outcomes in schizophrenia using electronic health record data.Schizophrenia Research. 2023;260:191-197. doi:10.1016/j.schres.2023.08.023
Biagianti B, Quraishi SH, Schlosser DA.Potential benefits of incorporating peer-to-peer interactions into digital interventions for psychotic disorders: A systematic review.Psychiatr Serv. 2018;69(4):377-388. doi:10.1176/appi.ps.201700283
Amore M, D’Andrea M, Fagiolini A.Treatment of agitation with lorazepam in clinical practice: A systematic review.Front Psychiatry. 2021;12:628965. doi:10.3389/fpsyt.2021.628965
Zareifopoulos N, Panayiotakopoulos G.Treatment options for acute agitation in psychiatric patients: Theoretical and empirical evidence.Cureus.2019.doi:10.7759/cureus.6152
Gammon D, Cheng C, Volkovinskaia A, Baker GB, Dursun SM.Clozapine: Why is it so uniquely effective in the treatment of a range of neuropsychiatric disorders?Biomolecules. 2021;11(7):1030. doi:10.3390/biom11071030
Tiihonen J, Tanskanen A, Taipale H.20-year nationwide follow-up study on discontinuation of antipsychotic treatment in first-episode schizophrenia.AJP. 2018;175(8):765-773. doi:10.1176/appi.ajp.2018.17091001
Stroup TS, Gray N.Management of common adverse effects of antipsychotic medications.World Psychiatry.2018;17(3):341-356. doi:10.1002/wps.20567
Francis M.Cortical activation and cognitive performance during repetitive transcranial magnetic stimulation in first-episode psychosis: A pilot study.clinicaltrials.gov; 2019. https://clinicaltrials.gov/ct2/show/NCT02131129
Craig TK, Rus-Calafell M, Ward T, et al.AVATAR therapy for auditory verbal hallucinations in people with psychosis: a single-blind, randomised controlled trial.The Lancet Psychiatry. 2018;5(1):31-40. doi:10.1016/S2215-0366(17)30427-3
Sistig B, Lambrecht I, Friedman SH.Journey back into body and soul – An exploration of mindful yoga with psychosis.Psychosis. 2015;7(1):25-36. doi:10.1080/17522439.2014.885556
Gaughran F, Stringer D, Berk M, et al.Vitamin D supplementation compared to placebo in people with First Episode psychosis - Neuroprotection Design (Dfend): a protocol for a randomised, double-blind, placebo-controlled, parallel-group trial.Trials. 2020;21(1):14. doi:10.1186/s13063-019-3758-9
Cha HY, Yang SJ.Anti-inflammatory diets and schizophrenia.Clin Nutr Res. 2020;9(4):241-257. doi:10.7762/cnr.2020.9.4.241
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