top of page

Management of a relapse or an acute episode

The risk of relapse is reduced in schizophrenia with the use antipsychotic drugs; however it does not prevent relapse in all patients. This apparent treatment failure may be a result of poor medication compliance. Nevertheless, a considerable proportion of patients with schizophrenia, who have been compliant with antipsychotic medication, still relapse; for reasons which are unknown.


When a relapse or an acute episode is suspected in an individual where a diagnosis of schizophrenia has been established, the crisis section of the care plan should be referred to by primary healthcare professionals and managed according to the plan. Patients can also be referred to the appropriate secondary mental health services such a crisis resolution and home treatment team or an acute hospital. If a person refuses necessary admission to hospital, compulsory admission can be arranged under sections 2, 3, or 4 of the Mental Health Act.


Furthermore psychological interventions should be offered to patients to promote recovery. Psychological interventions that are available consist of:
• Cognitive behavioural therapy, with at least 16 planned sessions.
• Family intervention for the relatives of people with schizophrenia who live with, or who are in close contact with, the affected person. This consists of 10 planned sessions over 3 months to 1 year.
• Arts therapies may be offered, particularly to help with negative symptoms.

The algorithms below are produced by the Maudsley Hospital and are examples of how a relapse or an acute episode of schizophrenia can be managed (Figures 10 and 11). 



Figure 10: Management of relapse or acute episode of schizophrenia (full adherence to medication confirmed).

​Figure 11: Treatment of relapse or acute episode of schizophrenia (adherence doubtful or known to be poor).

bottom of page