Antipsychotic medications may cause side effects like drowsiness, restlessness, or metabolic effects, though everyone reacts differently.

Schizophrenia is a chronic mental health condition that affects brain function. A person with this condition may experience episodes of psychosis, in which their perceptions, beliefs, or emotions appear disconnected from reality.

It’s estimated that globally 1% of adults are affected by schizophrenia. Because it can manifest in as a variety of symptoms, schizophrenia can be difficult to diagnose.

If you have been diagnosed with schizophrenia, you may be wondering what comes next.

The great news is that many effective treatment options are available, such as medications or talk therapy. An essential step in this journey is to explore your options and begin treatment quickly after diagnosis. This can help get your healing and recovery process started, bringing you a sense of direction and relief.

Learning more about the different medications used to treat schizophrenia may help you feel better prepared and ready to discuss your options with your treatment team.

Medications are an essential part of a treatment plan and can relieve symptoms of schizophrenia, such as delusions or hallucinations, allowing a person to function more effectively. The most commonly prescribed types of medications for schizophrenia are typical and atypical antipsychotics.

These medications are available as:

  • tablets
  • injections
  • liquids

Typical antipsychotics

Typical antipsychotics are known as first-generation antipsychotics and were developed in the 1950s. A few examples of typical antipsychotics include:

  • Haldol (haloperidol)
  • Thorazine (chlorpromazine)
  • Stelazine (trifluoperazine)
  • Loxitane (loxapine)

Atypical antipsychotics

Atypical antipsychotics are known as second-generation antipsychotics. These medications are generally the first course of treatment because they have a lower risk of serious side effects. A few examples of atypical antipsychotics include:

Clorazil is usually prescribed only when other antipsychotics aren’t successful at relieving symptoms or when a person also experiences suicidal thoughts. This is because Clorazil is the only atypical medication indicated to help reduce suicidal thoughts. Still, it also has an increased risk of lowering a person’s white blood cell count. Your healthcare provider will need to monitor your white blood cell count initially every 1 to 2 weeks.

Are you in a crisis or considering suicide?

If you’re having thoughts of suicide or self-harm, you can access free support right away with these resources:

  • The National Suicide Prevention Lifeline. Call the Lifeline at 800-273-8255, 24 hours a day, 7 days a week.
  • The Crisis Text Line. Text HOME to the Crisis Text Line at 741741.
  • The Trevor Project. LGBTQIA+ and under 25 years old? Call 866-488-7386, text START to 678678, or chat online 24-7.
  • Veterans Crisis Line. Call 800-273-8255, text 838255, or chat online 24-7.
  • Befrienders Worldwide. This international crisis helpline network can help you find a local helpline.
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Typical antipsychotics are known to increase the risk of a serious long-term side effect known as tardive dyskinesia that affects motor functions and movement. Someone with tardive dyskinesia may experience uncontrollable movements such as blinking your eyes, lip-smacking, sticking your tongue out, sucking, or chewing repeatedly.

A few short-term side effects of typical antipsychotics include:

  • drowsiness
  • restlessness
  • muscle spasms
  • dry mouth
  • blurred vision
  • tremor
  • constipation

Atypical antipsychotics are considered safer in regard to tardive dyskinesia, but they’re more likely to contribute to metabolic side effects such as:

  • low blood pressure
  • weight gain
  • increased blood sugar levels, which may lead to diabetes

Everyone is different, and bodies respond differently to medications. One person may experience benefits and minimal side effects from a particular medication, while someone else taking that same medication may experience severe side effects with no benefit at all.

Before you start taking antipsychotics, your doctor will likely ask you about your medical history and other medications or supplements you’re taking. This helps them determine a potentially suitable antipsychotic.

Try not to be discouraged if the first antipsychotic is not effective in managing your symptoms. Often it takes several tries before you find the best medication that works for you.

It’s highly advisable to discuss side effects you may be experiencing with your treatment team, so you can work together on minimizing side effects or finding the medication that relieves your symptoms the best and causes fewer side effects.

There are a few ways to reduce common side effects from antipsychotic medications.

For example, your doctor may suggest lowering your dose or changing your dosing schedule (e.g., once a day to twice a day), which may relieve side effects like drowsiness, dry mouth, blurred vision, or hypotension.

In some cases, additional medications can help alleviate side effects. For constipation, your doctor may suggest taking a stool softener or laxative. If weight gain is a concern for you, metformin may be added to your treatment plan, or lifestyle modifications may be recommended, such as getting more exercise or eating a balanced diet may help as well.

Medication compliance

When a healthcare professional talks about “medication compliance” they mean taking medications consistently and as prescribed. It may sound easy to take your medications regularly and as scheduled, but medication compliance can be a challenge for some people with schizophrenia.

The Food and Drug Administration (FDA) provides a few tips to help with taking your medications consistently:

  • Take your medication at the same time each day.
  • Use a daily routine to tie taking your medications with, such as brushing your teeth or a certain mealtime.
  • Keep a calendar so you can check off taking your medications each day.
  • Use a labeled pill container.

Plus, new treatment options have been developed to help make it easier for people to take their medications. Long-acting injectables (LAI) are administered by a healthcare professional every few weeks to few months. They can help people experience long-term, consistent symptom relief without the difficulty of having to remember to take medication daily.

Treatment-resistant schizophrenia

Up to 30% of people with schizophrenia don’t respond to two or more antipsychotic medications. This is known as treatment-resistant schizophrenia (TRS).

Clorazil (clozapine) is the only evidence-based treatment for TRS, with 60–70% of people treated with Clorazil showing a positive response.

Though Clorazil has a higher risk of serious side effects, including effects on your white blood cell count, it is safe to use with careful monitoring.

Schizophrenia is a chronic mental health condition that is characterized by symptoms like delusions and hallucinations. The most commonly prescribed medications for schizophrenia are typical and atypical antipsychotics.

Atypical antipsychotics are generally first-line medications for treating schizophrenia because typical antipsychotics have a higher risk of a serious side effect known as tardive dyskinesia. Atypical antipsychotics are more likely to have metabolic side effects, such as weight gain.

Your doctor may suggest lowering the dose of a medication, adding other medications, or increasing exercise if you’re concerned about weight gain as potential ways to help reduce the side effects of antipsychotics.

Being compliant with your treatment plan is vital for overall success. This includes:

  • taking medications consistently
  • letting your healthcare professional know if you’re experiencing side effects
  • being patient with yourself
  • reminding yourself that this is a journey

It can be tricky and sometimes frustrating to figure out the antipsychotic that works best for you. Don’t hesitate to advocate for yourself and speak with your healthcare professional about any concerns you have with your antipsychotic medications or treatment plan.

Though living with schizophrenia can be challenging, you can live a fulfilling life with the right support and treatment plan by your side.