What to Expect From Schizophrenia Medications

Antipsychotic drugs can be a big help in managing your symptoms. But they can have side effects. Your doctor should talk with you about their benefits and risks.

Antipsychotic medications change the way some of your brain chemicals act.

These drugs can help with symptoms such as hearing voices or seeing things that aren't real. Each person responds to antipsychotic medications differently.

These drugs also take time to control different symptoms:

  • Within a few days, you may feel less agitated and your hallucinations may fade.
  • Within a few weeks, delusions often ease. A delusion is a false belief that you can’t let go of. An example of a delusion is believing that others are always trying to hurt you.
  • Within about 6 weeks, many people feel much better.

How well your medications work can depend on your age when the illness began, how bad your symptoms are, and lifestyle habits.

How Long You’ll Take Them

Each person is different. Some need to take schizophrenia medications for a short time. Others need them longer.

Sometimes, people need to try a different dose or medication. But you should never stop suddenly. If the doctor says you can stop a medication, you will taper off it, a little at a time.

Your doctor may suggest other ways to address so-called negative symptoms, which include social withdrawal, lack of motivation, or lack of emotional expression. Antipsychotics don't work as well for these kinds of symptoms.

Also, your doctor may prescribe antidepressants if you get depressed.

Older and Newer Antipsychotics

Older antipsychotic drugs -- known as typical or first-generation ones -- have been around for decades. Newer, or atypical antipsychotics may work better to improve:

  • Problems showing emotion
  • Trouble interacting with others
  • General symptoms of anxiety, guilt, tension, and poor attention or judgment

The older and newer antipsychotics share some side effects. For example, atypical antipsychotics generally seem less likely than typical ones to cause involuntary movements as a side effect.

You often take antipsychotics by pill. People who have trouble doing this may get a long-acting antipsychotic shot in the shoulder muscle or buttocks, sometimes once a month, at a doctor's office or hospital. It may help prevent relapses.

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Possible Side Effects

When you start to take an antipsychotic, take some time to adjust. Don't drive until you know how the medicine affects your alertness and reaction time.

In most cases, early side effects, such as drowsiness or dizziness, go away within days. If not, you can work with your doctor to manage this. A different dose or medication may help.

These are some of the more common side effects of antipsychotic medications:

  • Drowsiness
  • Dizziness when you change positions
  • Blurry vision
  • Dry mouth
  • Rapid heartbeat
  • Sensitivity to the sun
  • Skin rash
  • Menstrual problems
  • Problems with sex
  • Enlarged breasts

Both older and newer antipsychotics may cause a rare condition called neuroleptic malignant syndrome. Symptoms include:

  • High fever
  • Sweating
  • Big swings in blood pressure
  • Muscle stiffness

With long-term use, older and newer drugs may also cause a serious condition called tardive dyskinesia (TD). This is more likely with older antipsychotics, though.

TD causes random muscle movements such as facial grimacing, lip smacking, and eye blinking. It can:

  • Be mild or more severe
  • Develop slowly over months, years, or decades
  • Sometimes go away after stopping the medicine, but also may be permanent

The medications deutetrabenazine (Austedo) and valbenazine (Ingrezza) have proven effective in treating adults with TD.

Older antipsychotics are more likely to cause side effects such as:

  • Stiffness in arms and legs
  • Muscle spasms
  • Trouble swallowing
  • Tremors
  • Restlessness or pacing
  • Very slow movements
  • Changes in breathing and heart rate

Newer antipsychotic drugs are more likely to lead to weight gain. This can make you more likely to get diabetes and high cholesterol. For this reason, your doctor should regularly check your weight, blood sugar levels, and cholesterol levels.

Stay in close contact with your doctor about how you feel, and let her know about any side effects. There may be a way to stop or at least ease them.

WebMD Medical Reference Reviewed by Joseph Goldberg, MD on November 20, 2017

Sources

SOURCES:

Agency for Healthcare Research and Quality: "Antipsychotic Medicines for Treating Schizophrenia and Bipolar Disorder."

UpToDate: "Pharmacotherapy for schizophrenia: Long-acting injectable antipsychotic drugs."

HelpGuide.org: "Schizophrenia Treatment & Recovery."

Cleveland Clinic: "Schizophrenia."

National Alliance on Mental Illness: "Introduction: Mental Health Medications and Tardive Dyskinesia."

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