If you or a loved one has schizophrenia, you may wonder whether medication alone is enough to treat or prevent symptoms like hallucinations, delusions, and aggression. Eighty percent of people with this condition have a relapse within five years of their first episode.
A number of supplements are touted to help manage both the symptoms of schizophrenia and some of the side effects from medication. Research shows that some may help, but results on others are more mixed. And in many cases, longer and larger studies are needed.
“It’s really important to understand that these supplements should be used to enhance treatment with antipsychotic drugs, not replace it,” says Ryan Sultan, MD, an assistant professor of clinical psychiatry at Columbia University Irving Medical Center and medical director of Integrative Psych in Manhattan, New York.
Keep in mind that it’s always best to talk to your doctor before starting any supplements. Even though they don’t require a prescription, not all of them may be safe. It’s essential for your doctor to make sure there won’t be any interactions with your medicine or any unwanted effects.
Here’s a look at what the research shows and what psychiatrists recommend.
Omega-3 Fatty Acids
A review of 20 studies of almost 1,500 people with schizophrenia found that those taking omega-3 fatty acids reduced positive symptoms such as hallucinations and delusions. “It’s an anti-inflammatory, so it may help to reduce inflammation in the brain that contributes to symptoms of schizophrenia,” Sultan says.
They may work as a preventive, too, he says. One small study found that people ages 13-25 who were at high odds of having schizophrenia saw their risk reduced when they took a daily omega-3 supplement for 12 weeks. Larger, longer studies are needed to check those results.
People with schizophrenia also have a higher risk of getting heart disease, notes Adrian Preda, MD, a professor of clinical psychiatry and human behavior at the University of California, Irvine, School of Medicine and editor-in-chief of the American Psychiatric Association’s Psychiatric News.
A daily omega-3 supplement may help the heart and blood vessels, too. There are no official recommendations, but Sultan recommends a supplement with both eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Opt for a gram a day, and look for one with about 60% of the total amount from EPA.
Vitamin D
Research has shown that babies born with low vitamin D levels are more likely to have schizophrenia later in life. But that doesn’t prove that low vitamin D levels is the reason why those babies had schizophrenia much later on – many things affect risk. And there isn’t good evidence that if you take a vitamin D supplement as an adult, you’ll be less likely to have schizophrenia or reduce your symptoms.
One study, published in 2021 in JAMA Network Open, looked at 149 adults diagnosed with early psychosis. The result: There wasn’t any evidence that a vitamin D supplement improved either their mental or physical health.
“We do check vitamin D levels at least once a year in patients with schizophrenia, and if it is low – meaning anything under 30 nanograms per milliliter (ng/mL) – we will have them take a supplement,” Preda says.
In general, the National Institutes of Health recommends that most adults get 600 international units (IUs) of vitamin D a day, and 800 IUs in people over the age of 70.
B Vitamins
A large review of over 800 patients found that people who took high-dose B vitamins like B6, B8, and B12 along with their medications reduced symptoms of schizophrenia, compared with those who took medicines alone.
“The B vitamins lower your body’s levels of homocysteine, a substance which we know in large amounts can be toxic to your brain,” Sultan says. “They may also help to regulate levels of hormones such as dopamine, serotonin, and GABA, which can help to relieve schizophrenia symptoms.” These supplements seem most helpful when people start them early in their illness, he notes.
But it’s not clear that everyone with schizophrenia will benefit from taking a B vitamin supplement. Preda recommends testing for a gene change that makes it harder for the body to process folate (vitamin B9). People with that change seem to have a bigger drop in symptoms when they take B vitamins. A certain type of folate, l-methylfolate, may be better absorbed by the body, and more effective, than other forms. The usual dose is 15 mg a day, Sultan says.
Vitamin E
People with schizophrenia are usually treated with antipsychotic drugs. These meds can have side effects like tardive dyskinesia (TD), which cause stiff, jerky movements of your face and body that you can’t control. Taking vitamin E at the same time may help, Sultan says. A 2018 review found that vitamin E may help protect against TD, but it can’t treat the condition once it starts. “There’s little evidence it reduces schizophrenia symptoms themselves,” Sultan says.
It’s also not clear what dose of vitamin D works best. Studies have looked at everything from 600 to 1,600 IUs a day, Sultan notes.
Keep in mind that high levels of vitamin E are linked to a larger risk of bleeding. Talk to your doctor about whether you should take vitamin E, and at what dose.
Probiotics
These microorganisms live in your digestive tract and keep it healthy. “They reduce inflammation in your gut, which in turn may reduce inflammation in your brain,” Sultan says. “They also lower levels of a yeast called Candida albicans, which is found at higher levels in people with schizophrenia.”
A 2024 review of eight studies linked probiotics to a reduction in schizophrenia symptoms and relief of gut discomfort, too.
There are many kinds of probiotics on the market, so look for ones with two to four strains of either lactobacillus or bifidobacterium, Sultan suggests. You may want to purchase one that contains any or all of these four ingredients: Lactobacillus acidophilus, Bifidobacterium bifidum, Lactobacillus reuteri, and Lactobacillus fermentum. People with schizophrenia who took probiotics that had all those strains daily for 12 weeks, along with high doses of vitamin D, reported large improvements in their symptoms, according to a 2019 study. But there are no official recommendations on taking probiotics to help with schizophrenia, so it’s best to consult your doctor, as with any supplements.
Melatonin
Sleep disorders such as insomnia are often major problems for people with schizophrenia. But doctors don’t usually recommend prescription medications because, in rare cases, they can also trigger psychosis, Sultan says. In these cases, melatonin, a hormone your brain makes to regulate your sleep cycle, is a safer option.
A 2021 review of 15 studies found that melatonin may help to prevent weight gain if it’s started at the same time as schizophrenia medication. It also may help to lower cholesterol levels. Sultan recommends 2-5 mg at night, taken an hour or two before bedtime.
But again, talk with your doctor before you start taking any supplements, and only along with (not instead of) the treatments your doctor prescribes.
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