and Psychosis Treatment
Medications for Schizophrenia
Table of Contents
Since schizophrenia may not be a single
condition and its causes are not yet known, current treatment methods are based on both
clinical research and experience. These approaches are chosen on the basis of their
ability to reduce the symptoms of schizophrenia and to lessen the chances that symptoms
Medication for the Treatment of Schizophrenia
Antipsychotic medications have been available since the mid-1950s. They have greatly
improved the outlook for individual patients. These medications reduce the psychotic
symptoms of schizophrenia and usually allow the patient to function more effectively and
appropriately. Antipsychotic drugs are the best treatment now available, but they do not
cure schizophrenia or ensure that there will be no further psychotic episodes.
The choice and dosage of medication can be made only by a qualified physician who is well
trained in the medical treatment of mental disorders. The dosage of medication is
individualized for each patient, since people may vary a great deal in the amount of drug
needed to reduce symptoms without producing troublesome side effects.
The large majority of people with schizophrenia show substantial improvement when treated
with antipsychotic drugs. Some patients, however, are not helped very much by the
medications and a few do not seem to need them. It is difficult to predict which patients
will fall into these two groups and to distinguish them from the large majority of
patients who do benefit from treatment with antipsychotic drugs.
A number of new antipsychotic drugs (the so-called atypical antipsychotics)
have been introduced since 1990. The first of these, clozapine (Clozaril®), has been
shown to be more effective than other antipsychotics, although the possibility of severe
side effects in particular, a condition called agranulocytosis (loss of the white
blood cells that fight infection) requires that patients be monitored with blood
tests every one or two weeks. Even newer antipsychotic drugs, such as risperidone
(Risperdal®) and olanzapine (Zyprexa®), are safer than the older drugs or clozapine, and
they also may be better tolerated. They may or may not treat the illness as well as
clozapine, however. Several additional antipsychotics are currently under development.
Antipsychotic drugs are often very effective in treating certain symptoms of
schizophrenia, particularly hallucinations and delusions; unfortunately, the drugs may not
be as helpful with other symptoms, such as reduced motivation and emotional
expressiveness. Indeed, the older antipsychotics (which also went by the name of
neuroleptics), medicines like haloperidol (Haldol®) or chlorpromazine
(Thorazine®), may even produce side effects that resemble the more difficult to treat
symptoms. Often, lowering the dose or switching to a different medicine may reduce these
side effects; the newer medicines, including olanzapine (Zyprexa®), quetiapine
(Seroquel®), and risperidone (Risperdal®), appear less likely to have this problem.
Sometimes when people with schizophrenia become depressed, other symptoms can appear to
worsen. The symptoms may improve with the addition of an antidepressant medication.
Patients and families sometimes become worried about the antipsychotic medications used to
treat schizophrenia. In addition to concern about side effects, they may worry that such
drugs could lead to addiction. However, antipsychotic medications do not produce a
high (euphoria) or addictive behavior in people who take them.
Another misconception about antipsychotic drugs is that they act as a kind of mind
control, or a chemical straitjacket. Antipsychotic drugs used at the
appropriate dosage do not knock out people or take away their free will. While
these medications can be sedating, and while this effect can be useful when treatment is
initiated particularly if an individual is quite agitated, the utility of the drugs is not
due to sedation but to their ability to diminish the hallucinations, agitation, confusion,
and delusions of a psychotic episode. Thus, antipsychotic medications should eventually
help an individual with schizophrenia to deal with the world more rationally.
Learn more about Schizophrenia...
Men are not prisoners of fate, but only prisoners of their own minds.
-- Franklin D. Roosevelt