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Medications for Schizophrenia

by Amy Scholten, MPH

En Español (Spanish Version)
 

Here are the basics about each of the medicines below. Only the most common reactions are listed. Ask your doctor if you need to take any special steps. Use each of these drugs as advised by your doctor or the booklet they came with. If you have any questions, call your doctor.

Schizophrenia is treated with a certain type of drug. They are used to treat a wide range of problems such as hallucinations, confusion, or agitation. The type of drugs used depend on what problems a person is having.

Prescription Medicine

Antipsychotics

Schizophrenia is treated with anitpsychotics. Each one has its own risks and benefits. It may take time to find the right mix of drugs that works best.

The types are:

Typical (First Generation)

Common names::

  • Chlorpromazine
  • Fluphenazine
  • Haloperidol
  • Perphenazine
  • Thioridazine
  • Thiothixene
  • Trifluoperazine

These are used to treat symptoms such as hallucinations or delusions. The doctor will monitor how the drugs work. Changes can be made based on response or side effects.

Possible problems are:

  • Feeling tired or sleepy
  • Restlessness
  • Muscle spasms
  • Tremor
  • Dry mouth
  • Blurry vision
  • Problems with sex or desire for sex
  • Sudden drop in blood pressure
  • Gastrointestinal problems (nausea, vomiting, diarrhea, constipation, heartburn)
  • Milk production—can happen in males
  • Breast growth in males not related to weight gain
  • Problems passing urine

A serious long-term problem with taking these is tardive dyskinesia (TD). TD causes involuntary movements. They can happen anywhere in the body, but are most common with the mouth, lips, and tongue.

Atypical (Second Generation)

Common names:

  • Aripiprazole
  • Asenapine
  • Brexipiprazole
  • Cariprazine
  • Clozapine
  • Iloperidone
  • Lurasidone
  • Olanzapine
  • Paliperidone
  • Quetiapine
  • Risperidone
  • Ziprasidone

These can treat both positive and negative symptoms. Negative symptoms include apathy, sluggishness, or social withdrawal. They may also help with depression.

Possible problems are:

  • Weight gain
  • Higher cholesterol levels
  • Metabolic syndrome
  • Diabetes
  • Low blood pressure
  • Feeling sleepy
  • Constipation
  • Problems with sex or desire for sex
  • Milk production—mainly seen with risperidone
  • TD

Clozapine may be used if other drugs are not working. Its use is limited because of the problems it can cause. Though rare, a large drop in white blood cells can happen when taking this drug. This can lead to serious infections.

Shared Problems from Antipsychotics

Rarely, these drugs can cause neuroleptic malignant syndrome (NMS). This is a life-threatening condition that mainly happens in the first 2 weeks of treatment. Symptoms include fever, sweating, muscle stiffness, and lightheadedness. NMS needs to be treated right away.

Special Considerations

Sticking with a drug routine can be hard. Most drugs are taken as pills each day. But, there are some that can be taken as a shot once a month. This can make it easier to take the drugs as needed. Talk to your doctor to see if this is an option.

Calendars, phone apps, and pillboxes can help with organizing drugs so they can be taken at the right time. Have help from family so they know the schedule. Taking medicine as directed is a very important step in controlling symptoms.

When to Call Your Doctor

Call your doctor if the drugs do not seem to be working. You should also call if you have any reactions.

Precautions

When taking any medicine:

  • Take medicine as directed. Do not change the amount or the schedule.
  • Be aware of the side effects of your medicine. Tell your doctor if you have any
  • Talk to your doctor before you stop taking any prescription medicine.
  • Medicine can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one medicine. This includes over-the-counter products and supplements.
  • Plan for refills as needed.
REFERENCES:

Antipsychotic efficacy for schizophrenia. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T909261/Antipsychotic-Efficacy-for-Schizophrenia. Updated August 1, 2019. Accessed August 13, 2019.

Holder SD, Wayhs A. Schizophrenia. Am Fam Physician. 2014;90(11):775-782.

Medications for schizophrenia. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T905976/Medications-for-schizophrenia. Updated June 22, 2018. Accessed August 13, 2019.

Schizophrenia. Mental Health America website. Available at:
...(Click grey area to select URL)
Accessed August 13, 2019.

Schizophrenia. National Institute of Mental Health website. Available at: https://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml. Updated February 2016. Accessed August 13, 2019.



Last reviewed December 2018 by EBSCO Medical Review Board Adrian Preda, MD
Last Updated: 8/13/2019

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