Medications are the primary treatment for managing the symptoms of schizophrenia; however, they can sometimes have severe side effects, so regular monitoring is needed.

A combination of several medications may be the most effective treatment for schizophrenia. But it may take time to determine which medications will best control your symptoms, and it can be difficult to get through this period. Surrounding yourself with a support system-such as your family or a community-based rehabilitation program-can provide you with the help you need.

Medication Choices

The following medications are used to treat people with schizophrenia:

• First-generation antipsychotics, such as haloperidol (Haldol) or chlorpromazine (Thorazine), which are used to reduce anxiety and agitation, and to stop delusions and hallucinations. These medications can be very effective but often have significant side effects, such as tardive dyskinesia, which is a condition that causes uncontrolled body movements.
• Second-generation antipsychotics, such as risperidone (Risperdal), paliperidone (Invega), olanzapine (Zyprexa), ziprasidone (Geodon), and quetiapine (Seroquel). These medications effectively treat symptoms of schizophrenia and may help reduce the risk for relapse.
  • Clozapine, such as Clozaril or Leponex, is usually considered a second-generation antipsychotic. This drug is approved in the United States for treating suicidal behavior associated with schizophrenia. But in the U.S., your doctor will need special authorization to prescribe clozapine for schizophrenia symptoms, and special monitoring is needed when clozapine is used.

A combination of medications sometimes works best for controlling symptoms of schizophrenia. Other medications that are often used along with antipsychotic medications include:¹²

• Lithium carbonate, such as Lithobid, Lithane, and Eskalith, to regulate moods.
• Antianxiety medications, such as alprazolam (Xanax) and diazepam (for example, Valium), to reduce anxiety and nervousness.
• Anticonvulsant medications, such as carbamazepine (for example, Tegretol) and valproate (for example, Depakote), to reduce symptoms during relapse.
• Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) (for example, Zoloft or Celexa) or tricyclic antidepressants (for example, Pamelor), to reduce symptoms of depression that often occur along with schizophrenia.

What To Think About

Second-generation antipsychotics used to treat schizophrenia are less likely to cause certain side effects than first-generation antipsychotics. Second-generation antipsychotics may also be more effective in preventing relapse than first-generation medications.¹⁰ If you have been taking first-generation antipsychotics (such as haloperidol) and have experienced severe or bothersome side effects, talk with your doctor about whether a second-generation antipsychotic may work better for you.

If you stop taking your medications, you will probably have a relapse. Do not stop taking your medications until you first talk with your health professional about the risks and benefits.

Some side effects of antipsychotic medications (such as low blood pressure or tremors) can be serious.

• How to recognize signs of neuroleptic malignant syndrome. The first signs usually include high fever-between 102 F and 103 F-fast or irregular heartbeat, rapid breathing, and severe sweating.
• How to recognize the first signs of tardive dyskinesia. Some of the first signs may include lip-smacking or continuous chewing; tongue-twitching or thrusting the tongue out of the mouth; or quick, jerky movements (tics) of the head.