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Schizophrenia Treatment - Antipsychotic Medications

Rashmi Nemade, Ph.D. & Mark Dombeck, Ph.D.

Antipsychotic medications of all varieties come in tablet/pill and syrup formulations and are usually prescribed for once a day use. Some are also available in long-lasting "depot" forms that can be injected once or twice a month and still do the job. Injectable antipsychotics may be necessary in situations where patients will not voluntarily take their medications and must be forced to do so for relief of psychotic symptoms. Medications are generally only forced when this step is deemed necessary for safety reasons.

In addition to the antipsychotic medications mentioned above, doctors will also prescribe additional medications for schizophrenic patients to address other symptoms besides psychosis. Antidepressants and mood stabilizers may be used where mood symptoms are a problem, for instance, and benzodiazipines may be prescribed on a PRN ("as needed") basis for when anxiety is a significant factor.

Antipsychotic Medication Side Effects

Side effects of antipsychotic medications can be serious. One form of side effect, extrapyramidal symptoms (EPS), leave patients with body stiffness, tremor, slowed movement, loss of capability for facial expression, and restlessness. These symptoms result from the blockade of dopamine receptors, and are highly similar to Parkinson's disease, which also results from a dopamine deficiency. In general, typical medications produce more EPS than do atypicals; which is a primary reason why atypicals are increasingly popular.

Another potential adverse reaction to typical antipsychotic use is Tardive Dyskinesia (TD), which is a condition characterized by involuntary tic-like body movements, most often manifesting in mouth and facial twitching. The condition may range from mild to severe, and can be irreversible once it has occurred, although more commonly, partial or complete reversibility can be achieved.

Atypical medications are not without their side effects as well. These drugs cause weight gain, hyperglycemia (high blood sugar) and dyslipidemia (high cholesterol). Other side effects may include a decrease in sexual performance abilities and/or interest, menstrual problems, and sensitivity to sunburn or skin rashes.

Patients or family members should inform doctors when medication side effects occur. Doctors can sometimes prescribe different medications, change dosages or schedule, or prescribe an additional medication so as to control and minimize side effects.