Schizophrenia and Psychosis Care in Santa Monica

Who this is for

• Adults with an established diagnosis of schizophrenia or schizoaffective disorder who need ongoing outpatient medication management.
• Patients whose symptoms have persisted through two or more adequate antipsychotic trials.
• Patients and families seeking a second opinion when the diagnosis itself is unclear.
• People stepping down from a hospitalization or an intensive program and needing continuity of care.
• Therapists and primary care physicians who want psychiatric co-management for a patient with psychosis.

Diagnostic clarity first

Psychosis is a symptom, not a diagnosis. Before adjusting medication, the evaluation works through the alternatives: bipolar disorder with psychotic features, substance induced states, autoimmune and inflammatory causes, seizure-related phenomena, neurodegenerative illness, and the cognitive and social-cognitive deficits that are often mistaken for negative symptoms. Records, collateral history, and prior workup are reviewed as part of this process.

The clinical background for this approach is set out in the guide to understanding schizophrenia and psychosis.

Medication management, including clozapine

Ongoing care covers antipsychotic selection and cross-titration, long-acting injectable options, management of side effects such as weight gain, metabolic change, akathisia, and tardive dyskinesia, and the treatment of co-occurring depression, anxiety, and sleep disturbance. For treatment-resistant illness, clozapine is offered with the monitoring and titration support it requires.

Working with therapists, families, and programs

Good outcomes in psychosis rarely come from medication alone. Care here is coordinated with individual therapists, family clinicians, vocational and educational supports, and higher levels of care when they are needed.

When coordinated specialty care is the better fit

For a young adult in a first episode of psychosis, the evidence favors a coordinated specialty care team rather than an individual prescriber. In those cases the appropriate referral is to a program such as California OnTrack / Pand Health Coordinated Specialty Care, which provides team-based treatment and family education. Those resources are also where families should look for practical, family-facing guidance.