Research has found that antipsychotic medication is effective for treating the positive symptoms in schizophrenia. It is not known exactly how they work, but one common feature is the ability to block the action of a chemical messenger in the brain called dopamine. Research suggests that malfunction of this chemical messenger system, as well as others, causes symptoms of schizophrenia like hallucinations and delusions.
Prevent Relapse: Don’t Stop
All antipsychotic medication must be taken as prescribed. Their effects can sometimes be noticed within the same day of the first dose. However, the full benefit of the medication may not be realized until after a few weeks of treatment. So don’t stop taking your medication because you think it’s not working. Give it time!
Once you have responded to your prescribed treatment, it is important to continue. To prevent symptoms from coming back or worsening, do not abruptly stop taking your medications, even if you are feeling better. Stopping your medication can cause a relapse. Medication should only be stopped under your doctor’s supervision. If you want to stop taking your medication, talk to your doctor about how to correctly stop them.
Keep Working to Find the Right Fit
Sometimes the antipsychotic you first try may not lead to improvement in symptoms. This is because each person’s brain chemistry is unique. What works well for one person may not do as well for another. Be open to trying another medication or combination of medications in order to find a good fit. Let your doctor know if your symptoms have not improved and do not give up searching for the right medication!
Antipsychotic Medications
These are sometimes referred to as conventional, typical, or first-generation antipsychotic medications:
Chlorpromazine (Thorazine)
Fluphenazine (Prolixin)
Haloperidol (Haldol)
Loxapine (Loxitane or Loxapac)
Perphenazine (Trilafon)
Thiothixene (Navane)
Trifluoperazine (Stelazine)
These are sometimes referred to as atypical or second-generation antipsychotic medications:
Aripriprazole (Abilify)
Asenapine (Saphris)
Clozapine (Clozaril)
Iloperidone (Fanapt)
Lurasidone (Latuda)
Olanzapine (Zyprexa)
Paliperidone (Invega)
Quetiapine (Seroquel)
Risperidone (Risperdal)
Ziprasidone (Geodon)
Long-Acting Injectable Medications
Certain antipsychotic medications are available as long-acting injectables. These medications are given every two to four weeks. Some people find these more convenient because they don’t have to take the medications daily. The side effects of these medications are similar to their oral counterparts.
Fluphenazine (Prolixin Decanoate)
Haloperidol (Haldol Decanoate)
Olanzapine (Zyprexa Relprevv)
Paliperidone (Sustena)
Risperdal (Consta)
Side Effects of Antipsychotic Medications
Like all medications, antipsychotic medications can have side effects. Your doctor will discuss some common side effects with you. In many cases, they are mild and tend to diminish with time. Some people have few or no side effects, and the side effects people typically experience are tolerable and subside in a few days.
Sometimes, common side effects can persist or become bothersome. If you experience such side effects, discuss them with your doctor and be sure to talk to them before making any decisions about discontinuing treatment. In rare cases, these medications can cause severe side effects. Contact your doctor immediately if you experience one or more severe symptoms.
Possible Medication Side Effects
Some individuals experience side effects that mimic symptoms of Parkinson’s disease, which are called parkinsonian or extrapyramidal symptoms. These include tremor, shuffling walk, and muscle stiffness. A related side effect is akathisia, which is a feeling of internal restlessness.
Additionally, prolonged use of antipsychotics may cause tardive dyskinesia, a condition marked by involuntary muscle movements in the face and body.
An uncommon, but serious side effect is called Neuroleptic Malignant Syndrome (NMS). These symptoms include high fever, muscle rigidity, and irregular heart rate or blood pressure. Contact your doctor immediately if any of these symptoms appear.
People taking antipsychotic medications can also experience a variety of other side effects including:
- Unusual dreams
- Blank facial expression
- Blurred vision
- Breast enlargement or pain
- Breast milk production
- Constipation
- Decreased sexual performance in men
- Diarrhea
- Dizziness or fainting when sitting or standing
- Difficulty urinating
- Drowsiness
- Dry mouth
- Excessive saliva
- Missed menstrual periods
- Mood changes
- Nausea
- Nervousness
- Restlessness
- Sensitivity to the sun
Weight Gain
Weight gain, changes in blood sugar regulation, and changes in blood levels of lipids (cholesterol and triglycerides) are common with some antipsychotics. Therefore, your doctor will check your weight and blood chemistry on a regular basis. If you have a scale at home, you want to regularly check your own weight. Each of these medications differ in their risk for causing these side effects. If you start to gain weight, talk to your doctor. It may be recommended that you switch medications or begin a diet and exercise program.
Clozapine
Clozapine can cause agranulocytosis, which is a loss of the white blood cells that help a person fight off infection. Therefore, people who take clozapine must get their white blood cell counts checked frequently. This very serious condition is reversible if clozapine is discontinued. Despite this serious side effect, clozapine remains the most effective antipsychotic available and can be used safely if monitoring occurs at the appropriate time intervals
Keep Learning and Find Support
The most important thing is to keep learning about schizophrenia and find a safe place to ask questions and feel supported. We offer a free private Facebook group for families with schizophrenia and bipolar disorder. You can also subscribe to receive our newsletter so that you can receive our latest blog posts.
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This post provides only general information about antipsychotic medication. It does not cover all possible uses, actions, precautions, side effects, or interactions of the medicines mentioned. This information does not constitute medical advice or treatment and is not intended as medical advice for individual problems or for making an evaluation as to the risks and benefits of taking a particular medication. The treating physician, relying on experience and knowledge of the patient, must determine dosages and the best treatment for the patient.
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