Medications for Schizophrenia

Medications used to treat schizophrenia are called antipsychotics. The primary goal of antipsychotic drugs is to stabilize and eliminate psychosis, disorganized thinking, agitation, and even aggression. Antipsychotics are prescribed to treat people with thought disorders, mood disorders, and even dementia.

What Do Antipsychotics Do?

Antipsychotics function as dopamine antagonists by binding to the brain cells’ dopamine receptors that block dopamine transmission. Excess levels of dopamine which is a neurotransmitter, has been implicated in causing psychotic symptoms. Blocking dopamine transmission helps to reduce the over-stimulation of the brain which helps to reduce and eliminate psychosis, such as delusions and hallucinations.

Types of Antipsychotics

Older generation antipsychotic drugs can have many adverse side effects. Remember, You may respond differently to antipsychotic medications. This is why it is important for people taking an antipsychotic drug to be under the care of a psychiatrist who can monitor for any changes that may require immediate medical attention. Older generation antipsychotic drugs include:

•Mellaril
•Stelazine
•Trilafon
•Orap
•Haldol
•Prolixin
•Thorizine


Antipsychotics, such as Riperdal, Zyprexa, Prolixin, Stelazine, Thorazine, and Haldol can be given as in injection. Dosing for antipsychotics drugs start in the lower range and are gradually increased until symptoms are effectively controlled. Maximum improvement in symptoms may not be seen for several weeks or even several months. Typically, your psychiatrist will continue with an optimum dosage; then, the dose of the antipsychotic will be gradually reduced to the lowest effective maintenance level.

Atypical antipsychotics are a newer group of drugs which have fewer side-effects than the older antipsychotics. Atypical antipsychotics work directly with the dopamine and serotonin brain pathways. Atypical antipsychotic drugs include:s

•Clozaril
•Risperdal
•Zyprexa
•Seroquel
•Ability
•Geodon
•Symbyax
The Downfall of Antipsychotic Medications

All antipsychotic medications have common side effects, such as increased drowsiness, weight gain, blood pressure changes, and neuromuscular reactions, such as odd movement disorders including:

•Dystonia
•Tardive dyskinesia
•Akathisia
•Parkinsonian like symptopms.
Before you begin taking your medication, you should talk to your doctor about the common side effects. The mos timportant drug for you requires careful consideration from you and your doctor.

Do Antipsychotics Work?

It really doesn’t matter what symptoms you have when you are sick. Medication is what we rely on when we want a remedy for the flu or a more serious medical illness, such as Diabetes. Bascially, the only requirement I have is that the medication works. It is always a good feeling to know that when I take a medicine for the flu, it is going to make me feel better. But, is that the case with antipsychotic medications?


For psychotic disorders, such as schizophrenia, the American Psychiatric Association recommends taking antipsychotics. They strongly encourage you to talk with your doctor about what antipsychotic may be more effective in managing psychotic symptoms. This typically means that you may have a different response to any of the antipsychotic medications started. So, it could be a process of trial and error with selecting the best antipsychotic medication that is right for you.

A study done by the NIMH found that use of atypical antipsychotic medications, such as Zyprexa, also had a lower side effect profile and were even more effective than some of the older generation antipsychotics at managing psychotic symptoms and reducing the rate of hospitalizations for those with schizophrenia.

As more studies continue to take place on the effectiveness of antipsychotics, the news continues to be promising giving those with a diagnosis of schizophrenia hope at controlling symptoms and living life with purpose and passion.

Stephahie White, PsyD, PhD, LCSW, DCSW

References:

American Psychiatric Association. (1997). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association Publishing: Washington, D.C.


American Psychiatric Association (2004) Practice Guideline for the Treatment of Patients

With Schizophrenia. Second Edition.

Neuroscientific Basis and Practical Applications. (2002). New York, NY: Cambridge University

Press.

Kapmeyer A, Meyer C, Kochen MM and Himmel W (2005). Doctors’ strategies in prescribing drugs: the case of mood-modifying medicines. Family Practice 2006; 23: 73–79. Retrieved September 8, 2007 from the website: http://fampra.oxfordjournals.org/cgi/content/full/23/1/73

Lieberman, J.A., Stroup, T.S., McEvoy, J.P., Swartz, M.S., Rosenheck, R.A., Perkins,

D.O., Keefe, R.S.E., Davis, S.M., Davis, C.E., Lebowitz, B.D., Severe, J., Hsiao, J.K.

(2005). Effectiveness of Antipsychotic Drugs in Patients with Chronic Schizophrenia.

New England Journal of Medicine, (353), p.1209-1223.