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 , delirium, infection, medicine effects or depression, and need a medical check.