Medicines for Schizophrenia
Medicine can be a very effective part of your treatment plan for schizophrenia. There are many medicines that can help. Medicines may be used to treat a range of schizophrenia symptoms, but they are most helpful in reducing hallucinations and making thinking less disorganized and scary.
During a first psychotic episode or a relapse, you may have to go to a hospital to get the care that you need. If you already are using medicine, you may need the dose adjusted or the medicine changed. When your symptoms are better, you will probably need to continue to take medicines to help you manage your symptoms as part of your recovery. Talk with your healthcare provider before making any changes in your medicines.
Using more than one medicine may be the best treatment. Some people living with schizophrenia may need to try more than one medicine to feel better. There are many to choose from. It may take some time to find which medicines are best for you. This may be frustrating.
When you are starting or making changes to your medicine, it may help to:
Get support from your family and your friends
Get help from a community-based rehab (rehabilitation) program
Talk with and get support from others who have had trouble finding the right medicines
Medicines sometimes have side effects, some of which can be severe. You and your healthcare provider should keep in touch about how they are working and how you are feeling. If you feel a medicine isn't right for you, your healthcare provider can help you find a new one. Don't stop taking your medicines without talking with your healthcare provider.
Types of medicine
Medicines used most often to treat schizophrenia include:
First generation antipsychotics, such as haloperidol, perphenazine, and chlorpromazine. They are used to reduce positive symptoms of schizophrenia (delusions and hallucinations). These medicines can work very well but can have side effects. These side effects include muscle trembling or stiffness, sleepiness, and weight gain. The most troublesome are the ones which cause uncontrolled body movements such as tardive dyskinesia.
Second generation antipsychotics, such as risperidone and aripiprazole. These medicines effectively treat symptoms of schizophrenia and may help reduce the risk of relapse, but also have side effects. The most troublesome is their effect on weight and blood sugar.
Clozapine. This medicine is used to treat severe schizophrenia that has not gotten better with other treatment. It is also used for suicidal behavior caused by schizophrenia. Your healthcare provider needs special permission to prescribe clozapine for treating schizophrenia. You will need to have your blood cells monitored as often as once a week if you take clozapine.
All of these medicines can help the symptoms of schizophrenia. Which medicine is best for you usually depends on how well a medicine has worked in the past for you and its side effects. Your healthcare provider will help you find the best medicine for you.
The following medicines may be prescribed along with antipsychotic medicines, including clozapine:
Lithium carbonate. This medicine regulates moods. You will need your blood tested every week when you first start taking it and every 6 or 12 months after you know the correct dose. These tests check the levels of lithium carbonate in your blood, because too much can be dangerous.
Antianxiety medicines, such as clonazepam and diazepam. These medicines reduce anxiety and nervousness.
Certain anticonvulsant medicines, such as carbamazepine and valproate. These medicines can keep your mood stable and reduce symptoms during a relapse.
Antidepressant medicines, such as selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants. These medicines reduce symptoms of depression that often occur along with schizophrenia.
Some side effects of antipsychotic medicines don’t happen often but can be serious. They include:
Neuroleptic malignant syndrome. This is a rare but life-threatening side effect of antipsychotics. The first signs usually include a fever between 102°F (38.9°C) and 103°F (39.4°C), a fast or irregular heartbeat, rapid breathing, and severe sweating.
Tardive dyskinesia. This is body movement that you can't control. Signs may include lip-smacking or continuous chewing, tongue-twitching or thrusting the tongue out of the mouth, or quick and jerky movements (tics) of the head.
The more common side effects of antipsychotic medicines can include:
You can work with your healthcare provider to choose a medicine that has a side effect profile that you can handle.
Because of side effects or the risk of side effects, you may be tempted to stop using your medicine. But if you stop using medicine, the symptoms of schizophrenia may come back or get worse.
If you have any concerns about side effects, talk with your healthcare provider. They will work with you.
Your healthcare provider may:
Give you another medicine to treat the side effect
Have you try another antipsychotic medicine
Give you a smaller dose of the antipsychotic medicine
You may need regular blood tests to check for side effects when you are taking medicines for schizophrenia. Children, teens, and older adults may need to have blood tests more often than other people.
What to think about
It can be tough to take medicines as part of your treatment. Many people wonder if they can manage the illness without them. If you are wondering this, talk with your healthcare provider before making any changes. It is possible that if you stop taking your medicines, you may have a relapse. Your team is there to work with you to find the treatments that work and best suit your needs and your life. If you and your healthcare team decide you should stop using medicine, you will need to be checked on a regular basis.
If you are pregnant or thinking of becoming pregnant, talk with your healthcare provider. Taking certain medicines for schizophrenia during pregnancy may make birth defects more likely. Having a relapse of schizophrenia is also dangerous for your baby. Your healthcare provider can work with you to plan your pregnancy so that there will be as little risk as possible to you and your baby.