What are the best medications for schizophrenia?

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Schizophrenia is a potentially serious mental health condition that affects how a person feels, thinks, and behaves. It can cause serious disturbances to someone’s social, work, and home life.

However, with proper treatment, an individual can live a fulfilling, independent life, attend school or work with no issues, and maintain relationships with others.

Several medications may help with treating schizophrenia. Health experts divide them into several broad types, which include:

• antipsychotics, which help manage psychosis relating to schizophrenia
• mood stabilizers, which may help prevent manic-type behaviors
• antidepressants, which help prevent depressive episodes

Antipsychotics are the first line of treatment for schizophrenia. These medications help prevent psychosis, a condition that makes it difficult for a person to determine what is real and what is not.

Schizophrenia can cause psychosis, which can include symptoms such as:

• Hallucinations: When a person hears, sees, tastes, feels, or smells something that is not there.
• Delusions: When someone has strong beliefs in something with no basis in reality.
• Movement disorder: When a person moves in an atypical manner.
• Thought disorder: When an individual has trouble concentrating, thinking, and speaking in a coherent manner.

Antipsychotics work by controlling the levels of dopamine and serotonin in the brain. These chemicals affect a person’s mood, how they move, and how they experience rewards.

In many cases, symptoms, such as hallucinations and delusions, will go away within a few weeks of starting antipsychotics.

Types

Antipsychotics break down into conventional and atypical.

Doctors have prescribed conventional antipsychotics for years, but these may cause several side effects.

Atypical antipsychotics are newer forms of medication that have a lower risk of serious side effects compared with conventional antipsychotics. However, they can cause other side effects.

Examples

Conventional antipsychotics for schizophrenia include:

• chlorpromazine
• haloperidol
• fluphenazine

Atypical antipsychotic examples include:

• quetiapine
• aripiprazole
• risperidone

Side effects

Both conventional and atypical antipsychotics can cause side effects.

Conventional antipsychotics may cause the following:

• tremors
• dystonia, or involuntary muscle contractions
• tardive dyskinesia, which causes uncontrollable muscle movements, often from long-term use

Additionally, atypical antipsychotics may cause changes in metabolism, which could increase the risk of diabetes or weight gain and kidney or bladder issues.

Learn more

Learn more about medications for schizophrenia.

• MNT investigates: Second-generation antipsychotic drugs for schizophrenia.
• How effective is Risperdal at treating schizophrenia?
• Does CBD oil help schizophrenia?

Doctors often prescribe mood stabilizers to treat bipolar disorder. They can use them off-label to treat mood disorders associated with schizophrenia.

In schizophrenia, mood stabilizers may help with mood symptoms due to psychosis. However, studies have shown they may not be effective for everyone. People often need to combine them with other medications for them to work.

According to a 2020 study, little evidence suggests they are beneficial for treating mood symptoms relating to schizophrenia, but doctors continue to prescribe them.

The authors suggest additional research is necessary to assess the benefits versus the risks of using the medications for schizophrenia.

Types

There are two types of mood stabilizers for schizoaffective disorder, which include lithium and valproic acid. Doctors will typically prescribe these with additional medication.

Examples

Two examples of mood stabilizers for schizoaffective disorder include lithium and valproic acid, and both come in different types and dosages. A doctor will determine what dose may work best for a person.

There are many other types of mood stabilizers. A person should speak with a doctor to discuss which one is most appropriate for them.

Side effects

Both lithium and valproic acid can cause side effects.

Lithium can cause side effects such as:

• diarrhea
• headaches
• hand tremors
• nausea or vomiting
• increased urination
• dizziness or drowsiness
• changes in appetite
• an acne-like rash
• dry mouth
• increased thirst
• hair loss or thinning hair

Valproic acid can cause several common side effects that can include:

• headache
• abdominal pain
• dizziness
• nausea and vomiting
• diarrhea
• dizziness
• tremor
• alopecia
• constipation
• insomnia
• depression
• rash
• tinnitus
• blurred vision

Both medications can cause more serious side effects, though they are less common. A person should talk with their doctor if they notice any unusual symptoms after starting the medication.

Certain antidepressants may improve negative symptoms relating to schizophrenia. These negative symptoms can include:

• difficulty showing emotions
• a loss of motivation
• difficulty functioning typically
• a loss of interest or enjoyment in daily activities
• withdrawal from social life

According to a 2020 study, little evidence suggests antidepressants are beneficial for treating schizoaffective disorder. Still, doctors continue to prescribe them as an add-on therapy.

The researchers suggest additional research is necessary to assess the benefits and risks of these medications for schizophrenia.

Types

Though there are several different types of antidepressant medications, doctors often prescribe selective serotonin reuptake inhibitors (SSRIs) to treat people with schizophrenia.

These medications help regulate the amount of serotonin in the brain to help improve mood.

Examples

Some examples of SSRI inhibitors include:

• Paroxetine (Paxil, Pexeva)
• Citalopram (Celexa)
• Fluoxetine (Prozac)
• Escitalopram (Lexapro)
• Sertraline (Zoloft)

Side effects

Some common side effects of antidepressants for schizophrenia can include:

• tiredness
• weight gain
• nausea
• vomiting
• sexual problems
• diarrhea

Medication can help a person with schizophrenia, but it may not be enough in all cases. A person will likely benefit from a multifaceted approach incorporating additional therapies and support.

Some nondrug treatments a doctor may recommend may include:

• Psychosocial therapies: These can include cognitive behavioral therapy, cognitive remediation interventions, behavioral skills training, or supported employment.
• Support groups: A healthcare professional may be able to direct a person to local support groups for those with schizophrenia, their family, and friends.
• Assertive community treatment: This can help prevent repeated hospitalization and homelessness.
• Coordinated specialty care: This can often help with the first episodes of psychosis and getting a person back into their everyday life.

If a person needs help managing their mental health, they can visit the National Institute of Mental Health website to search for local therapists.

Schizophrenia involves episodes of psychosis. Antipsychotic medications can help limit and reduce the severity of these symptoms and help a person live a fulfilling life.

Additional medications, such as mood stabilizers and antidepressants, may also help treat additional symptoms of schizophrenia.

Therapy and support programs can also offer additional treatment avenues to a person with the condition.