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Commonly Prescribed Medications For Schizophrenia

Trade Name Generic Name FDA Approved Age
Abilify aripiprazole 10 and older for bipolar disorder, manic or mixed episodes;
13 to 17 for schizophrenia and bipolar;
Clozaril clozapine 18 and older
Fanapt iloperidone 18 and older
fluphenazine (generic only) fluphenazine 18 and older
Geodon ziprasidone 18 and older
Haldol haloperidol 3 and older
Invega paliperidone 18 and older
Loxitane loxapine 18 and older
Moban molindone 18 and older
Navane thiothixene 18 and older
Orap (for Tourette’s syndrome) pimozide 12 and older
perphenazine (generic only) perphenazine 18 and older
Risperdal risperidone 13 and older for schizophrenia;
10 and older for bipolar mania and mixed episodes;
5 to 16 for irritability associated with autism
Seroquel quetiapine 13 and older for schizophrenia;
18 and older for bipolar disorder;
10-17 for treatment of manic and mixed episodes of bipolar disorder.
Stelazine trifluoperazine 18 and older
thioridazine (generic) thioridazine 2 and older
Thorazine chlorpromazine 18 and older
Zyprexia olanzapine 18 and older; ages 13-17 as second line treatment
for manic or mixed episodes of bipolar disorder
and schizophrenia.
Possible Side Effects of Medications for Schizophrenia

Some people have side effects when they start taking these medications. Most side effects go away after a few days and often can be managed successfully. People who are taking antipsychotics should not drive until they adjust to their new medication. Side effects of many antipsychotics include:

  • Drowsiness
  • Dizziness when changing positions
  • Blurred vision
  • Rapid heartbeat
  • Sensitivity to the sun
  • Skin rashes
  • Menstrual problems for women

Atypical antipsychotic medications can cause major weight gain and changes in a person’s metabolism. This may increase a person’s risk of getting diabetes and high cholesterol. A person’s weight, glucose levels, and lipid levels should be monitored regularly by a doctor while taking an atypical antipsychotic medication.

Typical antipsychotic medications can cause side effects related to physical movement, such as:
  • Rigidity
  • Persistent muscle spasms
  • Tremors
  • Restlessness

schizophreniaLong-term use of typical antipsychotic medications may lead to a condition called tardive dyskinesia (TD). TD causes muscle movements a person can’t control. The movements commonly happen around the mouth. TD can range from mild to severe, and in some people the problem cannot be cured. Sometimes people with TD recover partially or fully after they stop taking the medication.

Every year, an estimated 5 percent of people taking typical antipsychotics get TD. The condition happens to fewer people who take the new, atypical antipsychotics, but some people may still get TD. People who think that they might have TD should check with their doctor before stopping their medication.

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Treating Schizophrenia with Medication

Antipsychotic medications are used to treat schizophrenia and schizophrenia-related disorders. Some of these medications have been available since the mid-1950’s. They are also called conventional “typical” antipsychotics. Some of the more commonly used medications include:

  • Chlorpromazine (Thorazine)
  • Haloperidol (Haldol)
  • Perphenazine (generic only)
  • Fluphenazine (generic only)

In the 1990’s, new antipsychotic medications were developed. These new medications are called second generation, or “atypical” antipsychotics.

One of these medications was clozapine (Clozaril). It is a very effective medication that treats psychotic symptoms, hallucinations, and breaks with reality, such as when a person believes he or she is the president. But clozapine can sometimes cause a serious problem called agranulocytosis (which is a loss of the white blood cells that help a person fight infection). Therefore, people who take clozapine must get their white blood cell counts checked every week or two. This problem and the cost of blood tests make treatment with clozapine difficult for many people. Still, clozapine is potentially helpful for people who do not respond to other antipsychotic medications.

Other atypical antipsychotics were developed. All of them are effective. Agranulocytosis is less likely to occur with these medications than with clozapine, but it has been reported. These include:

  • Risperidone (Risperdal)
  • Olanzapine (Zyprexa)
  • Quetiapine (Seroquel)
  • Ziprasidone (Geodon)
  • Aripiprazole (Abilify)
  • Paliperidone (Invega)

The antipsychotics listed here are some of the medications used to treat symptoms of schizophrenia.

Note: The FDA issued a Public Health Advisory for atypical antipsychotic medications. The FDA determined that death rates are higher for elderly people with dementia when taking this medication. A review of data has found a risk with conventional antipsychotics as well. Antipsychotic medications are not FDA-approved for the treatment of behavioral disorders in patients with dementia.

Antipsychotics are usually pills that people swallow, or liquid they can drink. Some antipsychotics are shots that are given once or twice a month.

Symptoms of schizophrenia, such as feeling agitated and having hallucinations, usually go away within days. Symptoms like delusions usually go away within a few weeks. After about six weeks, many people will see a lot of improvement.

However, people respond in different ways to antipsychotic medications, and no one can tell beforehand how a person will respond. Sometimes a person needs to try several medications before finding the right one. Doctors and patients can work together to find the best medication or medication combination, and dose.

Some people may have a relapse—their symptoms come back or get worse. Usually, relapses happen when people stop taking their medication, or when they only take it sometimes. Some people stop taking the medication because they feel better or they may feel they don’t need it anymore. But no one should stop taking an antipsychotic medication without talking to his or her doctor. When a doctor says it is okay to stop taking a medication, it should be gradually tapered off, never stopped suddenly.

How do antipsychotics interact with other medications?

Antipsychotics can produce unpleasant or dangerous side effects when taken with certain medications. For this reason, all doctors treating a patient need to be aware of all the medications that person is taking. Doctors need to know about prescription and over-the-counter medicine, vitamins, minerals, and herbal supplements. People also need to discuss any alcohol or other drug use with their doctor.

To find out more about how antipsychotics work, the National Institute of Mental Health (NIMH) funded a study called CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness). This study compared the effectiveness and side effects of five antipsychotics used to treat people with schizophrenia. In general, the study found that the older medication perphenazine worked as well as the newer, atypical medications. But because people respond differently to different medications, it is important that treatments be designed carefully for each person.


Source: National Institute of Mental Health

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