What to Know About Schizophrenia Relapses
“Complete remission of schizophrenia symptoms is uncommon,” says Sophia Frangou, MD, PhD, a professor of psychiatry at the Icahn School of Medicine at Mount Sinai in New York City. “Most people will experience a recurrence of symptoms.”
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Preparing for an Acute Schizophrenia Episode
Warning Signs of a Schizophrenia Relapse
Some schizophrenia relapses occur without warning, but when early signs are present, they’re usually a return of early symptoms that occurred in the past.
- Agitation, irritability, or tension
- Changes in usual eating patterns
- Depression or anxiety
- Difficulty concentrating
- Difficulty keeping up with personal hygiene
- Disturbing or recurring thoughts
- Hallucinations
- Increasing paranoia or suspiciousness
- Insomnia
- Loss of interest in usual activities
- Social withdrawal
Knowing these symptoms is important, but knowing the symptoms specific to each person with schizophrenia — called “relapse signatures” — is more important. Most people with schizophrenia will experience those early symptoms before a full relapse occurs.
“These warning symptoms can be very specific,” says Michael T. Compton, MD, MPH, a professor of psychiatry at Columbia University in New York City. “For one person, it may be insomnia or worries about the neighbors. For another person, it may be irritability or hearing whispers.”
In fact, the warning signs may be as specific as avoiding certain colors or foods, says Dr. Frangou.
That’s why it’s important to know the earliest symptoms of previous episodes and watch for them. “The first sign of a relapse is repeating symptoms of a previous episode,” says Frangou. Recognizing these symptoms early on can help ensure immediate steps are taken to get proper treatment, says Dr. Compton.
Common Causes of a Schizophrenia Relapse
Knowing the common causes of a schizophrenia relapse can tell you when to be on the lookout.
Stress is particularly problematic. “Stress may contribute to schizophrenia relapse, but symptoms of relapse can also increase stress,” she says.
First Steps to Take If a Schizophrenia Relapse Occurs
“You may not be able to prevent a schizophrenia relapse, but early recognition and treatment may prevent a hospital admission,” says Compton. “The first thing to do is call [the] doctor to find out if [your] medication needs to be adjusted or restarted.” Other strategies include:
- Staying on medication
- Avoiding drugs and alcohol
- Finding effective ways to cope with stress
- Having a social support system
- Not withdrawing from friends and loved ones
- Sleeping and eating well
Another important strategy to manage a schizophrenia relapse is to get education and counseling support for yourself and your family to help you learn how to live with the condition. “Increasing psychosocial treatments can be an important part of relapse prevention,” says Compton.
You may not always be able to prevent a schizophrenia relapse, but recognizing early symptoms and getting help right away can help prevent a more severe episode, he adds.
The Takeaway
- Even with treatment, many people with schizophrenia experience relapses, which can cause symptoms such as difficulty concentrating, insomnia, and social withdrawal.
- Not taking prescribed medications as directed is the most common cause of schizophrenia relapse.
- To mitigate the impact of a schizophrenia relapse, experts recommend staying on prescribed medications, avoiding drugs and alcohol, reducing stress levels, and other strategies.
- Rivelli A et al. Real-World Predictors of Relapse in Patients With Schizophrenia and Schizoaffective Disorder in a Large Health System. Schizophrenia. February 29, 2024.
- Correll CU et al. Benefits and Risks of Antipsychotic Discontinuation in People With First and Multi-Episode Psychotic Disorders or With Schizophrenia: Why, When, How and in Whom? Schizophrenia. December 17, 2025.
- Zipursky RB et al. Antipsychotic Discontinuation in Schizophrenia: Rational or Reckless? Schizophrenia. December 17, 2025.
- Gleeson JF et al. Systematic Review of Early Warning Signs of Relapse and Behavioural Antecedents of Symptom Worsening in People Living With Schizophrenia Spectrum Disorders. Clinical Psychology Review. February 2024.
- Gumley A et al. Early Signs Monitoring to Prevent Relapse in Psychosis and Promote Well-Being, Engagement, and Recovery: Protocol for a Feasibility Cluster Randomized Controlled Trial Harnessing Mobile Phone Technology Blended With Peer Support. JMIR Research Protocols. January 2020.
Angela D. Harper, MD
Medical Reviewer
Angela D. Harper, MD, is in private practice at Columbia Psychiatric Associates in South Carolina, where she provides evaluations, medication management, and psychotherapy for adul...
Chris Iliades, MD
Author
Chris Iliades, MD, is a full-time medical writer and journalist based in Boothbay Harbor, Maine. He practiced clinical medicine for 15 years before transitioning to medical writing...