What Are the Best Medications for Schizophrenia?

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Updated December 16, 2014.

Antipsychotic medications reduce the psychotic symptoms of schizophrenia and other mental illnesses, usually allowing a person to function more effectively and appropriately. Antipsychotic drugs are the best treatment for schizophrenia right now, but they don't cure schizophrenia or ensure that there will be no further psychotic episodes.

Dosages


The choice and dosage of medication can be made only by a qualified physician who is well trained in the medical treatment of mental disorders.


The dosage of medication is individualized for each patient, since people may vary a great deal in the amount of drug needed to reduce symptoms without producing troublesome side effects.

The Newer Antipsychotics: Better Options?


A number of new antipsychotic drugs (the so-called "atypical antipsychotics") have been introduced since 1990. The first of these, clozapine (Clozaril), has been shown to be more effective than other antipsychotics, although the possibility of severe side effects -- in particular, loss of infection-fighting white blood cells (agranulocytosis) -- requires that patients be monitored with blood tests every one or two weeks. After a year of stable white blood counts, blood can be drawn monthly.

Even newer antipsychotic drugs -- such as risperidone (Risperdal), aripiprazole (Abilify), quetiapine (Seroquel), and olanzapine (Zyprexa) -- are safer regarding tardive dyskinesia (TD) -- an involuntary movement disorder -- but many of the atypical drugs are more likely to contribute to metabolic side effects such as weight gain, increased glucose and lipids.

Targeting the Symptoms of Schizophrenia


Antipsychotic drugs are often very effective in treating certain symptoms of schizophrenia, particularly hallucinations and delusions. The drugs may not be as helpful with other symptoms, such as reduced motivation and emotional expressiveness.

The older antipsychotics, medicines like haloperidol (Haldol) or chlorpromazine (Thorazine), may even produce side effects that resemble the more difficult-to-treat symptoms. Lowering the dose or switching to a different medicine may reduce these side effects. The newer medicines, including olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal), and aripiprazole (Abilify), appear less likely to cause this problem.

Sometimes when people with schizophrenia become depressed, other symptoms can appear to worsen. The symptoms may improve with the addition of an antidepressant medication.

Patients and families sometimes become worried about the antipsychotic medications used to treat schizophrenia. In addition to concern about side effects, they may worry that such drugs could lead to addiction. However, antipsychotic medications do not produce a "high" or addictive behavior in people who take them.

Another misconception about antipsychotic drugs is that they act as a kind of mind control, or a "chemical straitjacket." Antipsychotic drugs used at the appropriate dosage do not 'knock out' people or take away their free will.

Antipsychotic medications should eventually help an individual with schizophrenia to deal with the world more rationally.
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