What medication is used to treat schizophrenia?

How is schizophrenia usually treated?

The most severe symptoms of schizophrenia - hallucinations and delusions - are addressed with antipsychotic medication. Antipsychotics don’t cure schizophrenia. Instead, they help lessen the severity of psychotic symptoms and stabilize patients so they can lead a more normal life.^[1]

The same medication for schizophrenia doesn’t work for all people. In fact, what works well for one person might not have a perceptible effect on another person. Fortunately, there are different types of schizophrenia drugs your doctor or mental health provider might prescribe as part of your schizophrenia treatment.

Typical Antipsychotics

Typical antipsychotics, which are also referred to as first-generation or conventional antipsychotics, are an older type of drug that are dopamine receptor antagonists. These drugs inhibit the transmission of dopamine in the brain, improving primary schizophrenia symptoms.^[2]

However, typical antipsychotics are no longer preferred because the likelihood of severe side effects is much higher than with newer, atypical antipsychotics. The majority of psychiatrists-in-training have reservations about prescribing first-generation antipsychotics because of the risk of severe adverse effects ^[3], such as:

• Muscle stiffness or spasms
• Blurred vision
• Agitation
• Drowsiness
• Weight gain
• Dizziness
• Dry mouth
• Breast tenderness
• Emotional blunting

It should be noted that not all typical antipsychotic medications have the same side effects, nor do all drugs in this category produce the same severity of side effects.

Popular typical antipsychotics include the following:

• Pimozide
• Loxapine
• Trifluoperazine
• Perphenazine
• Mesoridazine
• Haloperidol
• Thiothixene

Atypical Antipsychotics

A far more common schizophrenia medication is atypical antipsychotics. These drugs, also known as second-generation antipsychotics, are preferred because of the lower risk of severe side effects. Second-generation antipsychotics are nearly always the first line of treatment for schizophrenia. ^[4,5]

Atypical antipsychotics have a different mechanism of action than their predecessors. These drugs are serotonin-dopamine antagonists, meaning they prevent the transmission of serotonin and dopamine rather than working only on dopamine as typical antipsychotics do.^[2]

Second-generation antipsychotics aren’t without concern about side effects, though. Some of the most common side effects of these schizophrenia drugs include the following:^[4]

• Blurred vision
• Dry mouth
• Dizziness
• Drowsiness
• Muscle stiffness or tremors
• Decreased sex drive or function

In rare cases, atypical antipsychotic drugs might also cause seizures.

While these schizophrenia medications have far fewer associated side effects, they do come with a risk of significant weight gain. The development of metabolic syndrome is also a concern.^[2]

Among the most popular atypical antipsychotic medications are:

• Risperidone
• Olanzapine
• Quetiapine
• Ziprasidone
• Clozapine

Other medications used to treat schizophrenia

Medication for schizophrenia isn’t just limited to antipsychotics. In some cases, antipsychotics aren’t effective enough in managing related symptoms (typically in cases of treatment-resistant schizophrenia). Depending on the presenting symptoms, you might be prescribed an antidepressant or a mood stabilizer. ^[6]

Antidepressant medication for schizophrenia

People with schizophrenia can sometimes experience depression, too. If an antipsychotic treatment doesn’t have the desired effect on depressive symptoms, such as low mood, flat affect, and suicidal ideation, an antidepressant might be prescribed.

The preferred antidepressants for this application are selective-serotonin reuptake inhibitors or SSRIs. This type of drug includes popular options like:^[6]

• Fluoxetine
• Sertraline
• Citalopram
• Paroxetine
• Escitalopram

Mood stabilizers as schizophrenia medication

Another option for treating depressive symptoms, mania, and anxiety in patients with schizophrenia are mood stabilizers. Like antidepressants, mood stabilizers might be prescribed along with an antipsychotic to achieve a better outcome than prescribing antipsychotics alone.

The most common mood stabilizers for schizophrenia include lithium and valproic acid. Both drugs are highly effective for treating other psychotic disorders and work in a reasonable percentage of people with schizophrenia.^[7]

Alternative treatment for schizophrenia

Since schizophrenia is a chronic disorder, treating it often involves both pharmacological and non-pharmacological approaches. Aside from the common drug treatments outlined earlier, mental health professionals often use psychotherapy to help treat individuals with schizophrenia. Therapy for schizophrenia would assist individuals in building insight into their mental health condition, improve coping skills, and increase the likelihood that patients can achieve higher functioning and independence.

Psychotherapy can take many different forms. Group therapy is an option for treating schizophrenia because of the positive benefits of its social and interactive characteristics. Individual psychotherapy is perhaps even more common. Individual therapy typically focuses on providing emotional support, social skills training, and vocational support.^[5]

Even more popular is cognitive-behavioral therapy or CBT. This type of therapy is highly effective in treating various psychological disorders because it helps you identify distorted or negative thoughts and how they impact your behavior. Moreover, CBT can help you alleviate the stress you experience due to your schizophrenia, reduce symptoms of anxiety and depression, and help you be more hopeful for the future.^[8]

You can also try some self-help techniques to manage your day-to-day symptoms and improve your daily functioning. These techniques include the following:^[9]

• Adhere to your treatment plan: Follow your doctor’s orders, take your medications as prescribed, and participate in therapy according to the direction of your mental health provider.
• Practice self-care: Get rest, eat well, exercise, and avoid using alcohol or abusing drugs.
• Participate in a support group: If group therapy isn’t part of your treatment, it’s worth it to seek out a local support group for people with schizophrenia.
• Get educated about your condition: The more you know, the better you will understand the signs and symptoms of schizophrenia, and the better you will be able to manage them.
• Ask for help when needed: You don’t have to go through this alone. Seeking professional help is paramount to your mental health. So too is asking loved ones for help when necessary.
• Find ways to relax: Doing yoga, meditation, mindfulness exercises, or similar activities can help you manage stress and anxiety and lower the risk of a psychotic episode.