People who are new to taking an antipsychotic, or are taking higher doses, can experience some side effects. One of the most common is drowsiness.
Antipsychotics are a class of medications that are typically used to manage symptoms of psychosis, which may occur in schizophrenia or bipolar disorder. These meds may also be prescribed for several other mental health conditions.
In some people, drowsiness is mild and goes away over time. In others, this side effect can be severe, interfering with daily tasks at work and school, or in relationships.
If you suspect your antipsychotic medication is causing extreme daytime drowsiness — and it’s unwelcome — you can take certain steps to combat this feeling.
Antipsychotic medications are believed to help manage your moods by affecting neurotransmitters in your brain, specifically dopamine, the “feel good” neurotransmitter.
These drugs are considered the first-line treatment for people with schizophrenia, and used in many people with bipolar disorder. They can be prescribed for other conditions as well.
There are two different types of antipsychotic medications: first generation (typical) and second generation (atypical).
Second generation antipsychotics are now more often prescribed than first generation due to fewer side effects. However, they can still cause side effects, including drowsiness — sometimes called sleepiness, somnolence, or sedation.
Typical antipsychotics include:
- chlorpromazine (Thorazine)
- fluphenazine (Prolixin)
- haloperidol (Haldol)
- perphenazine (Trilafon)
- pimozide (Orap)
- thiothixene (Navane)
Atypical antipsychotics include:
- aripiprazole (Abilify)
- asenapine (Saphris)
- cariprazine (Vraylar)
- clozapine (Clozaril)
- lurasidone (Latuda)
- olanzapine (Zyprexa)
- quetiapine (Seroquel)
- risperidone (Risperdal)
- ziprasidone (Geodon)
- paliperidone (Invega)
Drowsiness with antipsychotics
Depending on the person, drowsiness can either be considered a welcome, positive side effect or a negative, unwanted one.
During an episode of mania in bipolar disorder, people can go without sleep for days at a time without feeling tired. In many conditions, insomnia can occur as well, especially during periods of depression.
In cases such as these, drowsiness can be a welcome side effect.
On the other hand, when you want or need to stay awake — like during the day or at work — drowsiness may not be desired.
The antipsychotic you take may make a difference in how drowsy you feel.
Some antipsychotics are more likely to cause drowsiness than others.
According to
High somnolence:
- clozapine (Clozaril)
Moderate somnolence:
- olanzapine (Zyprexa)
- perphenazine (Trilafon)
- quetiapine (Seroquel)
- risperidone (Risperdal)
- ziprasidone (Geodon)
Low somnolence
- aripiprazole (Abilify)
- asenapine (Saphris)
- cariprazine (Vraylar)
- haloperidol (Haldol)
- lurasidone (Latuda)
- paliperidone (Invega)
Drowsiness, like other side effects, can be mild and temporary. For some people, it might even be helpful if you’ve been having trouble falling asleep.
But if you’re having severe drowsiness during the day, this can begin to cause problems at work, school, or in daily functioning.
Drowsiness can also increase your chances of falling, which may lead to serious injury. It can even affect your ability to drive or operate machinery safely.
Many people who are new to taking antipsychotics or take higher doses might begin to suspect that the antipsychotic is what’s causing their severe drowsiness. If you’re tracking symptoms and side effects, you may also realize it sooner.
Some people opt to stop taking certain antipsychotics due to severe drowsiness.
If you begin to feel more tired than usual while taking an antipsychotic, there are several things you can do to help fight the drowsiness.
So… how can you fight your severe drowsiness without stopping the medication you need to help manage your condition?
Consider these 7 tips:
1. Practice good sleep hygiene
Getting a good night’s rest is essential to maintaining mental and physical well-being, but there are a lot of things that make up good sleep hygiene:
- maintain a regular sleep schedule (try to go to sleep at the same time every night)
- aim for between 7 and 9 hours of sleep
- avoid naps during the day
- avoid stimulants like caffeine, alcohol, and nicotine close to bedtime
- exercise regularly
- establish a bedtime routine
- avoid reading or watching TV in bed
- try to limit screen use for about an hour before going to sleep
2. Ask about other medications
Some medications have a higher chance of causing drowsiness (somnolence) than others.
Ask your prescriber if you can take an antipsychotic that’s less likely to cause this side effect.
3. Limit other things that make you drowsy
To prevent increasing the drowsiness you’re already experiencing, you can limit other substances and medications that also cause drowsiness.
For example, alcohol. This can make you feel even more drowsy.
If you’re unsure what medications could cause increased drowsiness, ask a pharmacist or other healthcare provider.
4. Consider your timing
You may want to rethink the timing of when you take your antipsychotic. For instance, consider taking it at night to lower your daytime drowsiness.
5. Ask about dosing
Ask your treatment team about lowering the dose of your antipsychotic. Higher doses can increase side effects such as drowsiness.
6. Wait it out
When first starting a medication, side effects are more common. You may want to wait at least 2 weeks to build up a tolerance to your med.
After the first 2 weeks, your drowsiness or other side effects should begin to lessen. Just keep your prescriber informed in case it doesn’t.
7. Ask about alternative options
Ask your healthcare team if there are supplements or other meds you can take to combat the drowsiness and help boost your alertness during the day.
A combination of treatments may help fight some side effects, such as drowsiness. And if not, you can always talk with your doctor about tweaking your treatment plan.
If you’re just starting a new antipsychotic medication that may cause drowsiness, try to avoid activities that require alertness — such as driving — until you find out how the med affects you.
In some cases, the drowsiness will go away over time as your body adjusts to the new medication. However, if it’s excessive or begins to affect your ability to function during the day, talk with your healthcare team.
Treating mental health conditions often involves some trial and error. But relieving your drowsiness may be as simple as adjusting the dose or switching to a different antipsychotic.
Finding the right combination of treatments can take some time, so give yourself the grace to be patient with the process. Work with your treatment team to find a plan that you can tolerate and works best for you.