Schizophrenia Medications: Types, Side Effects, Effectiveness

Schizophrenia medications are typically antipsychotic medications. These drug treatments for schizophrenia are specifically used to treat the positive symptoms associated with psychosis, such as hallucinations and delusions. Schizophrenia medication is normally prescribed by a psychiatrist and might be taken orally or by long-acting injection. Antipsychotics for schizophrenia can allow people with this mental illness to live normal and fulfilling lives in the community.

Antipsychotics for schizophrenia consists of typical and atypical antipsychotics, also known as neuroleptics. Atypical antipsychotics are the preferred treatment today. Typical antipsychotics are considered first-generation antipsychotics and were the first medications developed to treat psychosis.

Typical or Conventional Antipsychotic Medications for Schizophrenia

Typical antipsychotics, also known as conventional antipsychotics or major tranquilizers, were first developed in the 1950s for the treatment of psychosis. Conventional antipsychotics block two types of chemical receptors in the brain – receptors for dopamine and serotonin. Chlorpromazine (Thorazine) was the first conventional antipsychotic developed for schizophrenia.

Conventional antipsychotics are measured via potency when compared to chlorpromazine (Thorazine). The potency of antipsychotic medication indicates how much medication is needed in order to achieve the desired effects to that of 100 mg of chlorpromazine (Thorazine).¹

Low potency conventional antipsychotics include:

• Chlorpromazine (Thorazine)
• Thioridazine (Mellaril)

Medium potency conventional antipsychotics include:

• Loxapine (Loxapac, Loxitane)
• Molindone (Moban)
• Perphenazine (Trilafon)
• Thiothixene (Navane)
• Trifluoperazine (Stelazine)

High potency conventional antipsychotics include:

• Haloperidol (Haldol, Serenace)
• Fluphenazine (Prolixin)
• Zuclopenthixol (Clopixol)

Side Effects of Conventional Antipsychotics for Schizophrenia

Side effects vary depending on the antipsychotic, but the side effects of major concern are those that affect something called the extrapyramidal system. The extrapyramidal system is a part of the nervous system that controls motor function. Disruption of the extrapyramidal system can cause:

• Inner restlessness and an inability to sit still (akathisia)
• Tremor, rigidity, unsteadiness (parkinsonism)
• Repetitive movements or postures (dystonia)
• Involuntary body movements that may be slow (tardive dyskinesia)

The prevalence of tardive dyskinesia with conventional antipsychotics is about 30%.²

Atypical Antipsychotics for Schizophrenia

Atypical antipsychotics, also known as second generation antipsychotics, were first discovered in the 1950s but weren’t put into clinical practice until the 1970s. Atypical antipsychotics also alter dopamine and serotonin pathways in the brain but do so to a lesser extent. The first atypical antipsychotic was clozapine (Clozaril) but it has fallen out of use due to white blood cell side-effect concerns. Other atypical antipsychotics have mostly taken its place.³

Atypical antipsychotics for schizophrenia include:

• Aripiprazole (Abilify)
• Asenapine (Saphris)
• Clozapine (Clozaril)
• Lurasidone (Latuda)
• Olanzapine (Zyprexa)
• Paliperidone (Invega)
• Quetiapine (Seroquel)
• Risperidone (Risperdal)
• Ziprasidone (Geodon)

Side Effects for Atypical Antipsychotics for Schizophrenia

As with conventional antipsychotics, side effects vary by medication. While extrapyramidal (motor function) side effects are less common with atypical antipsychotics, they still can occur. Weight gain, blood sugar (diabetes) and cardiovascular issues are also of major concern with atypical antipsychotic treatment.

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