Schizophrenia
Medicines
Medicine is the most effective treatment for schizophrenia, and there are many medicines that can help. Medicines may be used for positive or negative symptoms, but they don't work as well for negative symptoms as they do for positive symptoms.
- During a first psychotic episode or a relapse, you probably will need constant care and may have to go to a hospital. If you already are using medicine, you may need higher doses or other adjustments.
- When your symptoms are better, you may need to continue to take medicines, sometimes in lower doses. Talk to your doctor before making any changes in your medicines.
Using more than one medicine may be the best treatment for schizophrenia, and there are many to choose from. But it may take time to find which medicines are best for you. This may be frustrating. Getting support from your family, your friends, and a community-based rehabilitation program is helpful, especially while you and your doctor are trying to find the best medicines. It also may help to speak with and get support from others who have had trouble finding the right medicines.
Medicines sometimes have severe side effects, so you and your doctor need to keep in touch about how they are working and how you are feeling. If you feel a medicine isn't right for you, your doctor can help you find a new one. Don't stop taking your medicines without talking to your doctor.
Medicine choices
Medicines used most often to treat schizophrenia include:
- First-generation antipsychotics, such as haloperidol (Haldol), perphenazine, and chlorpromazine. They are used to reduce anxiety and agitation and to stop delusions and hallucinations. These medicines can work very well but often have severe side effects, such as tardive dyskinesia, which causes uncontrolled body movements.
- Second-generation antipsychotics, such as risperidone (Risperdal), paliperidone (Invega), olanzapine (Zyprexa), ziprasidone (Geodon), and quetiapine (Seroquel). These medicines effectively treat symptoms of schizophrenia and may help reduce the risk of relapse.
- Clozapine, such as Clozaril. This medicine is approved in the United States for treating severe schizophrenia that has not improved with other treatment and for suicidal behavior caused by schizophrenia. In the U.S., your doctor needs special permission to prescribe clozapine for treating schizophrenia. You may need checkups as often as once a week if you take clozapine.
The first-generation and second-generation antipsychotic medicines both can help the symptoms of schizophrenia. Which medicine is best for you usually depends on how well a medicine has worked in the past for you and its side effects. Your doctor will help you find the best medicine for you.
The following medicines often are used along with antipsychotic medicines and clozapine:8
- Lithium carbonate, such as Lithobid and Eskalith. This medicine regulates moods. You will need your blood tested every week when you first start taking it and every 6 or 12 months after you know the correct dose. These tests check the levels of lithium carbonate in your blood, because too much can be dangerous.
- Antianxiety medicines, such as clonazepam (Klonopin) and diazepam (for example, Valium). These medicines reduce anxiety and nervousness.
- Anticonvulsant medicines, such as carbamazepine (for example, Tegretol) and valproate (for example, Depakote). These medicines can keep your mood stable and reduce symptoms during a relapse.
- Antidepressant medicines, such as selective serotonin reuptake inhibitors (SSRIs) (for example, Zoloft or Celexa) or tricyclic antidepressants (for example, Pamelor). These medicines reduce symptoms of depression that often occur along with schizophrenia.
Side effects
Some side effects of antipsychotic medicines can be serious.
- Neuroleptic malignant syndrome is a rare but life-threatening side effect of antipsychotics. The first signs usually include a fever between 102°F (38.9°C) and 103°F (39.4°C), a fast or irregular heartbeat, rapid breathing, and severe sweating.
- Tardive dyskinesia is body movement that you can't control. Signs may include lip-smacking or continuous chewing, tongue-twitching or thrusting the tongue out of the mouth, or quick and jerky movements (tics) of the head.
Because of side effects or the risk of side effects, you may be tempted to stop using your medicine. But if you stop using medicine, the symptoms of schizophrenia may come back or get worse.
If you have any concerns about side effects, talk to your doctor. He or she will work with you. Your doctor may give you a smaller dose of the antipsychotic medicine, have you try another antipsychotic medicine, or give you another medicine to treat the side effect.
You may need regular blood tests to check for side effects when you are taking medicines for schizophrenia. Children, teens, and older adults may need to have blood tests more often than other people.
What to think about
If you stop taking your medicines, you may have a relapse. Don't stop taking your medicines until you talk with your doctor. If you and your health care team decide you should stop using medicine, you will need to be checked on a regular basis.
Read about some ways to help you remember to take your medicine.
Taking medicines for schizophrenia during pregnancy may make birth defects more likely. If you are pregnant or thinking of becoming pregnant, talk to your doctor. Your doctor can help you plan your pregnancy so that there will be as little risk as possible to you and your baby.
Most people with schizophrenia qualify for health care programs such as Medicare or Medicaid. To find out whether you qualify, check with your local health and welfare agency.
 Go to previous section |  Go to top of page |  Go to next section |
| Author: |
Jeannette Curtis
Paul Lehnert |
Last Updated: August 28, 2008 |
| Medical Review: |
Steven L. Schneider, MD - Family Medicine
Miklos Ferenc Losonczy, MD, PhD - Psychiatry J. David Carroll, PhD - Psychology |
|
 | ||
