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Schizophrenia

Schizophrenia is a brain disorder that causes a person to:
  • Hear or see things that others do not
  • Feel like others are plotting against them
  • Have problems thinking clearly
  • Withdraw from others
There is no cure. It is managed with medicine and counseling. Natural therapies have been used to help ease symptoms. This does not replace the need for medicine.

Natural Therapies

Likely Effective

These therapies are likely to help ease symptoms:
  • d-Serine—an amino acid found in the brain A1-A2
  • Exercise U1, U2
  • Mindfulness exercises help a person become aware of their senses and feelings in the moment without judging them. R1-R3

May Be Effective

These herbs and supplements may help ease symptoms:
  • Ginkgo biloba is a large tree with fan-shaped leaves. H1-H5
  • N-acetylcysteine is an acid found in human cells. I1-I5
  • Omega-3 fatty acids are found in foods, such as fish and flaxseed. They can also be found in a supplement. J1-J7
  • Sarcosine is an amino acid. K1-K5
  • Vitamin supplements, such as B6, B8, B12, vitamin C , and folate L1-L7
These therapies have also been used:
  • Acupuncture B1, B2
  • Animal-assisted therapy X1
  • Art therapy C1-C3
  • Music therapy D1, D2
  • Physical therapy V1
  • Progressive muscle relaxation E1-E2
  • Repetitive transcranial magnetic stimulation (rTMS) is a form of brain stimulation therapy. F1-F9
  • Yoga G1-G6

Unlikely to Be Effective

  • Ayurvedic medicine is a holistic healing system from India. N1
  • Glycine is an amino acid. O1-O3
  • Hypnotherapy M1

Not Enough Data to Assess

  • Alpha-lipoic acid Q1
  • Cannabis P1-P3
  • Chinese calligraphy T1
  • Dance therapy Y1
  • Eicosapentaenoic acid Z1
  • Horticultural therapy W1
  • Probiotics AA1
  • Traditional Chinese medicine S1, S2
  • Tai Chi BB1
Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.
Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse.
  • Ginkgo biloba—May interact harmfully with many commonly prescribed medicines.
  • N-acetylcysteine—May not be advised based on side effects seen during trials, which increase with dosage. This may include nausea, vomiting, fever, or sore throat.
  • Vitamin B3—May cause flushing or redness on your face, if more than 100 mg a day are taken. If you are taking high doses, talk to your doctor about testing for liver function.
  • Vitamin B6—Doses as low as 200 mg a day may result in nerve damage.
  • Vitamin C— Excessive vitamin C may be associated with kidney stone formation. Don’t take vitamin C with iron supplements or blood thinners. Use caution when taking vitamin C and acetaminophen.

References

A
d-Serine
A1
Cho SE, Na KS, et al. Low d-serine levels in schizophrenia: A systematic review and meta-analysis. Neurosci Lett. 2016;634:42-51.
A2
Panizzutti R, Fisher M, et al. Association between increased serum d-serine and cognitive gains induced by intensive cognitive training in schizophrenia. Schizophr Res. 2018 Apr 23 [Epub ahead of print].
B
Acupuncture
B1
van den Noort M, Yeo S, et al. Acupuncture as add-on treatment of the positive, negative, and cognitive symptoms of patients with schizophrenia: a systematic review. Medicines (Basel). 2018 Mar 30;5(2).
B2
Shen X, Xia J, et al. Acupuncture for schizophrenia. Cochrane Database Syst Rev. 2014 Oct 20;(10):CD005475.
C
Art Therapy
C1
C1. Crawford MJ, Killaspy H, et al. Group art therapy as an adjunctive treatment for people with schizophrenia: multicentre pragmatic randomised trial. BMJ. 2012;344:e846.
C2
Ruiz MI, Aceituno D, et al. Art therapy for schizophrenia? Medwave. 2017;17(Suppl1):e6845.
C3
Qiu HZ, Ye ZJ, et al. Effect of an art brut therapy program called go beyond the schizophrenia (GBTS) on prison inmates with schizophrenia in mainland China-A randomized, longitudinal, and controlled trial. Clin Psychol Psychother. 2017;24(5):1069-1078.
D
Music Therapy
D1
Geretsegger M, Mössler KA, et al. Music therapy for people with schizophrenia and schizophrenia-like disorders. Cochrane Database Syst Rev. 2017;5:CD004025.
D2
Tseng PT, Chen YW, et al. Significant treatment effect of adjunct music therapy to standard treatment on the positive, negative, and mood symptoms of schizophrenic patients: a meta-analysis. BMC Psychiatry. 2016 Jan 26;16:16.
E
Progressive Muscle Relaxation
E1
Vancampfort D, Correll CU, et al. Progressive muscle relaxation in persons with schizophrenia: a systematic review of randomized controlled trials. Clin Rehabil. 2013;27(4):291-298.
E2
Wang FZ, Luo D, et al. Combined intervention with education and progressive muscle relaxation on quality of life, functional disability, and positive symptoms in patients with acute schizophrenia. J Altern Complement Med. 2015;21(3):159-165.
F
Repetitive Transcranial Magnetic Stimulation
F1
Tranulis C, Sepehry AA, et al. Should we treat auditory hallucinations with repetitive transcranial magnetic stimulation? A metaanalysis. Can J Psychiatry. 2008;53(9):577-586.
F2
Wobrock T, Guse B, et al. Left prefrontal high-frequency repetitive transcranial magnetic stimulation for the treatment of schizophrenia with predominant negative symptoms: a sham-controlled, randomized multicenter trial. Biol Psychiatry. 2015;77(11):979-988.
F3
Dougall N, Maayan N, et al. Transcranial magnetic stimulation (TMS) for schizophrenia. Cochrane Database Syst Rev. 2015;(8):CD006081.
F4
Bais L, Liemburg E, et al. Effects of low frequency rTMS treatment on brain networks for inner speech in patients with schizophrenia and auditory verbal hallucinations. Prog Neuropsychopharmacol Biol Psychiatry. 2017;78:105-113.
F5
Iimori T, Nakajima S, et al. Effectiveness of the prefrontal repetitive transcranial magnetic stimulation on cognitive profiles in depression, schizophrenia, and Alzheimer's disease: A systematic review. Prog Neuropsychopharmacol Biol Psychiatry. 2019 Jan 10;88:31-40.
F6
Kennedy NI, Lee WH, et al. Efficacy of non-invasive brain stimulation on the symptom dimensions of schizophrenia: A meta-analysis of randomized controlled trials. Eur Psychiatry. 2018 Mar;49:69-77.
F7
Osoegawa C, Gomes JS, et al. Non-invasive brain stimulation for negative symptoms in schizophrenia: An updated systematic review and meta-analysis. Schizophr Res. 2018 Jul;197:34-44.
F8
He H, Lu J, et al. Repetitive transcranial magnetic stimulation for treating the symptoms of schizophrenia: A PRISMA compliant meta-analysis. Clin Neurophysiol. 2017 May;128(5):716-724.
F9
Dougall N, Maayan N, et al. Transcranial Magnetic Stimulation for Schizophrenia. Schizophr Bull. 2015 Nov;41(6):1220-1222.
G
Yoga
G1
Broderick J, Knowles A, et al. Yoga versus standard care for schizophrenia. Cochrane Database Syst Rev. 2015;(10):CD010554.
G2
Bhatia T, Mazumdar S, et al. A randomised controlled trial of adjunctive yoga and adjunctive physical exercise training for cognitive dysfunction in schizophrenia. Acta Neuropsychiatr. 2017;29(2):102-114.
G3
Broderick J, Vancampfort D. Yoga as part of a package of care versus non-standard care for schizophrenia. Cochrane Database Syst Rev. 2019 Apr 16;4:CD012807.
G4
Broderick J, Crumlish N, et al. Yoga versus non-standard care for schizophrenia. Cochrane Database Syst Rev. 2017 Sep 28;9:CD012052.
G5
Cramer H, Lauche R, et al. Yoga for schizophrenia: a systematic review and meta-analysis. BMC Psychiatry. 2013 Jan 18;13:32.
G6
Vancampfort D, Vansteelandt K, et al. Yoga in schizophrenia: a systematic review of randomised controlled trials. Acta Psychiatr Scand. 2012 Jul;126(1):12-20.
H
Ginkgo Biloba
H1
Zhang XY, Zhou DF, et al. A double-blind, placebo-controlled trial of extract of Ginkgo biloba added to haloperidol in treatment-resistant patients with schizophrenia. J Clin Psychiatry. 2001;62(11):878-883.
H2
Chen X, Hong Y, et al. Efficacy and safety of extract of Ginkgo biloba as an adjunct therapy in chronic schizophrenia: A systematic review of randomized, double-blind, placebo-controlled studies with meta-analysis. Psychiatry Res. 2015;228(1):121-127.
H3
Sarris J. Herbal medicines in the treatment of psychiatric disorders: 10-year updated review. Phytother Res. 2018;32(7):1147-1162.
H4
Siskind DJ, Lee M, et al. Augmentation strategies for clozapine refractory schizophrenia: A systematic review and meta-analysis. Aust N Z J Psychiatry. 2018 Aug;52(8):751-767.
H5
Singh V, Singh SP, et al. Review and meta-analysis of usage of ginkgo as an adjunct therapy in chronic schizophrenia. Int J Neuropsychopharmacol. 2010 Mar;13(2):257-271.
I
N-acetylcysteine
I1
Berk M, Copolov D, et al. N-acetyl cysteine as a glutathione precursor for schizophrenia--a double-blind, randomized, placebo-controlled trial. Biol Psychiatry. 2008;64(5):361-368.
I2
Farokhnia M, Azarkolah A, et al. N-acetylcysteine as an adjunct to risperidone for treatment of negative symptoms in patients with chronic schizophrenia: a randomized, double-blind, placebo-controlled study. Clin Neuropharmacol. 2013;36(6):185-192.
I3
Rapado-Castro M, Berk M, et al. Towards stage specific treatments: effects of duration of illness on therapeutic response to adjunctive treatment with N-acetyl cysteine in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry. 2015;57:69-75.
I4
Conus P, Seidman LJ, et al. N-acetylcysteine in a double-blind randomized placebo-controlled trial: toward biomarker-guided treatment in early psychosis. Schizophr Bull. 2018;44(2):317-327.
I5
Deepmala, Slattery J, et al. Clinical trials of N-acetylcysteine in psychiatry and neurology: A systematic review. Neurosci Biobehav Rev. 2015 Aug;55:294-321.
J
Omega-3 Fatty Acids
J1
Joy CB, Mumby-Croft R, et al. Polyunsaturated fatty acid supplementation for schizophrenia. Cochrane Database Syst Rev. 2006;(3):CD001257.
J2
Amminger GP, Schäfer MR, et al. Long-chain omega-3 fatty acids for indicated prevention of psychotic disorders: a randomized, placebo-controlled trial. Arch Gen Psychiatry. 2010;67(2):146-154.
J3
Pawełczyk T, Grancow-Grabka M, et al. A randomized controlled study of the efficacy of six-month supplementation with concentrated fish oil rich in omega-3 polyunsaturated fatty acids in first episode schizophrenia. J Psychiatr Res. 2016;73:34-44.
J4
Balanzá Martínez V. Nutritional supplements in psychotic disorders. Actas Esp Psiquiatr. 2017;45(Supplement):16-25.
J5
Behdani F, Roudbaraki SN, et al. Assessment of the efficacy of omega-3 fatty acids on metabolic and inflammatory parameters in patients with schizophrenia taking clozapine and sodium valproate. Psychiatry Res. 2018;261:243-247.
J6
Chen AT, Chibnall JT, et al. A meta-analysis of placebo-controlled trials of omega-3 fatty acid augmentation in schizophrenia: Possible stage-specific effects. Ann Clin Psychiatry. 2015 Nov;27(4):289-296.
J7
Chia SC, Henry J, et al. Fatty acid and vitamin interventions in adults with schizophrenia: a systematic review of the current evidence. J Neural Transm (Vienna). 2015 Dec;122(12):1721-1732.
K
Sarcosine
K1
Tsai G, Lane HY, et al. Glycine transporter I inhibitor, N-methylglycine (sarcosine), added to antipsychotics for the treatment of schizophrenia. Biol Psychiatry. 2004;55(5):452-456.
K2
Singh SP, Singh V. Meta-analysis of the efficacy of adjunctive NMDA receptor modulators in chronic schizophrenia. CNS Drugs. 2011;25(10):859-885.
K3
Strzelecki D, Podgórski M, et al. Adding sarcosine to antipsychotic treatment in patients with stable schizophrenia changes the concentrations of neuronal and glial metabolites in the left dorsolateral prefrontal cortex. Int J Mol Sci. 2015;16(10):24475-24489.
K4
Strzelecki D, Kałużyńska O, et al. No changes of cardiometabolic and body composition parameters after 6-month add-on treatment with sarcosine in patients with schizophrenia. Psychiatry Res. 2015;230(2):200-204.
K5
Lin CY, Liang SY, et al. Adjunctive sarcosine plus benzoate improved cognitive function in chronic schizophrenia patients with constant clinical symptoms: a randomised, double-blind, placebo-controlled trial. World J Biol Psychiatry. 2017;18(5):357-368.
L
Vitamin Supplements
L1
Lerner V, Miodownik C, et al. Vitamin B6 as add-on treatment in chronic schizophrenic and schizoaffective patients: a double-blind, placebo-controlled study. J Clin Psychiatry. 2002;63(1):54-58.
L2
Lerner V, Bergman J, et al. Vitamin B6 treatment in acute neuroleptic-induced akathisia: a randomized, double-blind, placebo-controlled study. J Clin Psychiatry. 2004;65(11):1550-1554.
L3
Dakhale GN, Khanzode SD, et al. Supplementation of vitamin C with atypical antipsychotics reduces oxidative stress and improves the outcome of schizophrenia. Psychopharmacology (Berl). 2005;182(4):494-498.
L4
Roffman JL, Lamberti S, et al. Randomized multicenter investigation of folate plus vitamin B12 supplementation in schizophrenia. JAMA Psychiatry. 2013;70(5):481-489.
L5
Firth J, Stubbs B, et al. The effects of vitamin and mineral supplementation on symptoms of schizophrenia: a systematic review and meta-analysis. Psychol Med. 2017 Jul;47(9):1515-1527.
L6
Magalhães PV, Dean O, et al. Antioxidant treatments for schizophrenia. Cochrane Database Syst Rev. 2016 Feb 5;2:CD008919.
L7
Chia SC, Henry J, et al. Fatty acid and vitamin interventions in adults with schizophrenia: a systematic review of the current evidence. J Neural Transm (Vienna). 2015 Dec;122(12):1721-1732.
M
Hypnotherapy
M1
Izquierdo de Santiago A, Khan M. Hypnosis for schizophrenia. Cochrane Database Syst Rev. 2007;(4):CD004160.
N
Ayurvedic Medicine
N1
Agarwal V, Abhijnhan A, et al. Ayurvedic medicine for schizophrenia. Cochrane Database Syst Rev. 2007;(4):CD006867.
O
Glycine
O1
Evins AE, Fitzgerald SM, et al. Placebo-controlled trial of glycine added to clozapine in schizophrenia. Am J Psychiatry. 2000;157(5):826-828.
O2
Tuominen HJ, Tiihonen J, et al. Glutamatergic drugs for schizophrenia. Cochrane Database Syst Rev. 2006;(2):CD003730.
O3
Buchanan RW1, Javitt DC, et al. The Cognitive and Negative Symptoms in Schizophrenia Trial (CONSIST): the efficacy of glutamatergic agents for negative symptoms and cognitive impairments. Am J Psychiatry. 2007;164(10):1593-1602.
P
Cannabis
P1
Hoch E, Niemann D, et al. How effective and safe is medical cannabis as a treatment of mental disorders? A systematic review. Eur Arch Psychiatry Clin Neurosci. 2019 Feb;269(1):87-105.
P2
Osborne AL, Solowij N, et al. A systematic review of the effect of cannabidiol on cognitive function: Relevance to schizophrenia. Neurosci Biobehav Rev. 2017 Jan;72:310-324.
P3
McLoughlin BC, Pushpa-Rajah JA, et al. Cannabis and schizophrenia. Cochrane Database Syst Rev. 2014 Oct 14;(10):CD004837.
Q
Alpha-lipoic Acid
Q1
de Sousa CNS, da Silva Leite CMG, et al. Alpha-lipoic acid in the treatment of psychiatric and neurological disorders: a systematic review. Metab Brain Dis. 2019 Feb;34(1):39-52.
R
Mindfulness Exercises
R1
Li J, Shen J, et al. Mindful exercise versus non-mindful exercise for schizophrenia: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Clin Pract. 2018 Aug;32:17-24.
R2
Aust J, Bradshaw T. Mindfulness interventions for psychosis: a systematic review of the literature. J Psychiatr Ment Health Nurs. 2017 Feb;24(1):69-83.
R3
Khoury B, Lecomte T, et al. Mindfulness interventions for psychosis: a meta-analysis. Schizophr Res. 2013 Oct;150(1):176-84.
S
Traditional Chinese Medicine
S1
Wei YY, Lin WF, et al. Effectiveness of Traditional Chinese Medicine as as an Adjunct Therapy for Refractory Schizophrenia: A Systematic Review and Meta Analysis. Sci Rep. 2018 Apr 18;8(1):6230.
S2
Deng H, Xu J. Wendan decoction (Traditional Chinese medicine) for schizophrenia. Cochrane Database Syst Rev. 2017 Jun 28;6:CD012217.
T
Chinese Calligraphy
T1
Chu KY, Huang CY, et al. Does Chinese calligraphy therapy reduce neuropsychiatric symptoms: a systematic review and meta-analysis. BMC Psychiatry. 2018 Mar 7;18(1):62.
U
Exercise
U1
Dauwan M, Begemann MJ, et al. Exercise Improves Clinical Symptoms, Quality of Life, Global Functioning, and Depression in Schizophrenia: A Systematic Review and Meta-analysis. Schizophr Bull. 2016 May;42(3):588-599.
U2
Gorczynski P, Faulkner G. Exercise therapy for schizophrenia. Cochrane Database Syst Rev. 2010 May 12;(5):CD004412.
V
Physical Therapy
V1
Vera-Garcia E, Mayoral-Cleries F, et al. A systematic review of the benefits of physical therapy within a multidisciplinary care approach for people with schizophrenia: An update. Psychiatry Res. 2015 Oct 30;229(3):828-839.
W
Horticultural Therapy
W1
Liu Y, Bo L, et al. Horticultural therapy for schizophrenia. Cochrane Database Syst Rev. 2014 May 19;(5):CD009413.
X
Animal-Assisted Therapy
X1
Kamioka H, Okada S, et al. Effectiveness of animal-assisted therapy: A systematic review of randomized controlled trials. Complement Ther Med. 2014 Apr;22(2):371-390.
Y
Dance Therapy
Y1
Ren J, Xia J. Dance therapy for schizophrenia. Cochrane Database Syst Rev. 2013 Oct 4;(10):CD006868.
Z
Eicosapentaenoic Acid
Z1
Fusar-Poli P, Berger G. Eicosapentaenoic acid interventions in schizophrenia: meta-analysis of randomized, placebo-controlled studies. J Clin Psychopharmacol. 2012 Apr;32(2):179-185.
AA
Probiotics
AA1
Ng QX, Soh AYS, et al. A Systematic Review of the Effect of Probiotic Supplementation on Schizophrenia Symptoms. Neuropsychobiology. 2019;78(1):1-6.
BB
Tai Chi
BB1
Yang GY, Wang LQ, et al. Evidence base of clinical studies on Tai Chi: a bibliometric analysis. PLoS One. 2015 Mar 16;10(3):e0120655.

Revision Information

  • Reviewer: EBSCO NAT Review Board Eric Hurwitz, DC
  • Review Date: 11/2019
  • Update Date: 06/17/2020
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