If you have schizophrenia, two specific neurotransmitters, serotonin and dopamine, may be out of balance. Your doctor may prescribe serotonin-dopamine activity modulators, or SDAMs. These drugs – also known as second-generation antipsychotics, or atypical antipsychotics – are taken as a tablet or capsule to help regulate your mood, emotions, and behavior. These medications, along with other antipsychotics, also have activity on other neurotransmitters.
Short- and long-term studies have shown that people with schizophrenia show improvement when using SDAMs.
How Do Serotonin and Dopamine Work?
Schizophrenia and other serious psychiatric disorders can be caused by an imbalance of chemicals that serve as messengers within the body. Those chemicals, known as neurotransmitters, send signals from the brain to your nerves, muscles, organs, and tissues.
Serotonin helps regulate your sleep, digestion, mood, and behavior. It’s also important for your sex drive, pain sensitivity, energy level, and feelings of aggression.
Dopamine is responsible for feelings of pleasure, movement, and emotions, as well as awareness and judgment.
SDAMs balance the work of serotonin and dopamine by stimulating some of their activity while blocking others.
Who Should Take SDAMs?
Antipsychotic medications have been used with success for many years to treat schizophrenia. But serious side effects keep some people from taking or sticking with those medications. Many doctors and patients prefer SDAMs because they have a lower risk of serious side effects than some of those earlier drugs.
When prescribing SDAMs, your psychiatrist will try to manage your symptoms with the lowest possible effective dose. Proper treatment may also involve combining those drugs with anti-anxiety medications, antidepressants, or other medications. Getting that balance right is very important, because if you have schizophrenia, you’ll need lifelong treatment.
Some seizure medications and mood stabilizers, and medications used to treat tuberculosis, may decrease the effects of SDAMs.
How Long Does It Take for SDAMs to Work?
It may take 2 to 3 months before you get the full benefit of SDAMs. Be sure to tell your doctor how you are responding to this drug when you first take it and if you have any side effects.
In the first 1 to 2 weeks, your hallucinations and disorganized thinking may get better, and you may be more motivated to be around people.
Your symptoms may continue to improve the longer you take SDAMs, but sometimes, they don’t go away completely.
What Are the Side Effects of SDAMs?
Some people using these medications have more thoughts about suicide. Let your doctor know if you have an increase in depression or if you are thinking about hurting yourself. Tell your doctor if you have trouble sleeping, get upset easily, have strange bursts of energy, or if you feel violent or scared.
You should also check with your psychiatrist if you have any of these symptoms while using this medicine: seizures, problems with your breathing, a rapid heartbeat, high fever, low or high blood pressure, loss of bladder control, muscle stiffness, pale skin, or tiredness. These may be signs of a serious condition called neuroleptic malignant syndrome (NMS).
Other side effects may include:
- Insomnia
- Weight gain
- Agitation
- Headache
- Drug-induced movement disorders, including dystonia (involuntary muscle contraction) and dyskinesia, (uncontrolled writhing movements)
- Indigestion, constipation, diarrhea
- Fatigue
- Speech disorders, such as stuttering
- Hepatitis
- Allergic reactions
- Deep vein thrombosis (blood clots in the veins)
One common side effect of schizophrenia medications is weight gain. To counter this, some SDAMs are prescribed with other drugs, known as opioid antagonists. That combination works to prevent a hunger sensation.
In some people, SDAMs have caused unusual changes in behavior. This includes urges to gamble, to binge eat, or to compulsively shop, or unexplained sexual urges. Talk with your doctor if these changes affect you. You should avoid drinking alcohol or using illegal drugs while taking these medications. That combination can make you more confused and increase other adverse side effects.
Talk to all of your doctors if you are or plan to become pregnant. SDAMs can cause serious side effects in both mother and baby. Because there are many side effects with SDAMs, always check with your doctor and pharmacist to make sure these medications don’t interfere with any other treatments. And don’t stop taking your medications or change your dose without talking to your doctor.
What SDAMs Are Available?
Your doctor will work with you to decide which SDAM may work best for you. You should schedule regular visits to allow for any changes in doses that may be needed. These SDAMs are approved by the FDA for the treatment of schizophrenia. They are:
