Schizophrenia in special cases (pregnancy, children, elderly)

Schizophrenia needs extra care in pregnancy, in children and teenagers and in older adults. Treatment decisions in each group should be made by a psychiatrist together with the person and the family, weighing risks and benefits.

Pregnancy and breastfeeding

• Do not stop medicine suddenly because of pregnancy. Relapse can harm both mother and baby.
• Plan pregnancy in advance with the psychiatrist and obstetrician. Some antipsychotics are considered safer than others, and doses may be adjusted.
• Avoid valproate and other medicines that harm the baby, as advised by the doctor.
• After delivery the risk of relapse is higher, so extra support and monitoring are needed.
• Breastfeeding decisions depend on the medicine, so ask the doctor.

Children and teenagers

• Early-onset schizophrenia before 18 is uncommon but serious. Warning signs include withdrawal, falling school performance, odd beliefs and hearing voices.
• A child and adolescent psychiatrist should assess the child, because other conditions such as depression, trauma, autism or substance use can look similar.
• Treatment includes carefully chosen medicine, therapy, family support and help with school.
• Avoid cannabis and other drugs.

Older adults

• Schizophrenia can continue into old age or begin late. New hallucinations or beliefs in an older person may also be due to dementia, delirium, infection, medicine effects or depression, and need a medical check.
• Older people are more sensitive to side effects such as falls, stiffness, confusion and heart rhythm problems, and doses are usually lower.
• Regular physical health checks and review of all medicines are needed.

Ayurvedic view (interpretive) Herbal or traditional products should not be used in pregnancy, in children or in elderly people with other illnesses without the psychiatrist's agreement. Evidence is limited.

Urgent help Seek help at once (112) for suicidal talk, violence, severe confusion or refusal to eat or drink. Tele-MANAS 14416 offers free support.

Remember Never stop or change medicine on your own. Ask the psychiatrist how treatment should be adjusted for the person's age or pregnancy.