People who are new to taking an antipsychotic or are taking higher doses can experience side effects. One of the most common is drowsiness.

Antipsychotics are a class of medications typically used to manage symptoms of psychosis, which may occur in schizophrenia or bipolar disorder. These meds may also be prescribed for several other mental health conditions.

In some people, drowsiness is mild and goes away over time. In others, this side effect can be severe, interfering with daily tasks at work and school or in relationships.

If you suspect your antipsychotic medication is causing extreme daytime drowsiness — and it’s unwelcome — you can take certain steps to manage this.

Antipsychotic medications are believed to help manage your moods by affecting neurotransmitters in your brain, specifically dopamine, a “feel good” neurotransmitter.

These drugs are considered the first-line treatment for people with schizophrenia and are used for many people with bipolar disorder. They can be prescribed for other conditions as well.

There are three types of antipsychotic medications:

  • first generation (aka typical)
  • second generation (aka atypical)
  • third generation

Second- and third-generation antipsychotics are more often prescribed than first-generation antipsychotics due to fewer side effects. However, like any medication, they can still cause side effects, including drowsiness — sometimes called sleepiness, somnolence, or sedation.

First-generation or typical antipsychotics include:

  • chlorpromazine (Thorazine)
  • fluphenazine (Prolixin)
  • haloperidol (Haldol)
  • perphenazine (Trilafon)
  • pimozide (Orap)
  • thiothixene (Navane)

Second-generation or atypical antipsychotics include:

Third-generation antipsychotics include:

Drowsiness with antipsychotics

Depending on the person, drowsiness can either be considered a welcome, positive side effect or a negative, unwanted one.

During an episode of mania in bipolar disorder, people can go without sleep for days at a time without feeling tired. In many conditions, insomnia can occur as well, especially during periods of depression.

In cases such as these, drowsiness can be a welcome side effect.

On the other hand, when you want or need to stay awake — like during the day or at work — drowsiness may not be wanted.

The antipsychotic you take may make a difference in how drowsy you feel.

Categories of antipsychotics

Some antipsychotics are more likely to cause drowsiness than others.

According to a 2023 research review, antipsychotics can be grouped into three categories based on the severity of drowsiness as a side effect: high somnolence, moderate somnolence, and low somnolence.

High somnolence:

  • clozapine (Clozaril)

Moderate somnolence:

  • olanzapine (Zyprexa)
  • perphenazine (Trilafon)
  • quetiapine (Seroquel)
  • risperidone (Risperdal)
  • ziprasidone (Geodon)

Low somnolence

  • aripiprazole (Abilify)
  • asenapine (Saphris)
  • cariprazine (Vraylar)
  • haloperidol (Haldol)
  • lurasidone (Latuda)
  • paliperidone (Invega)

Drowsiness, like other side effects, can be mild and temporary. For some people, it might even be helpful if you’ve been having trouble falling asleep.

But if you’re having severe drowsiness during the day, this can begin to cause problems at work, school, or in daily functioning.

Drowsiness can also increase your chances of falling, which may lead to serious injury. It can even affect your ability to drive or operate machinery safely.

Many people who are new to taking antipsychotics or take higher doses might begin to suspect that the antipsychotic is what’s causing their severe drowsiness. If you’re tracking symptoms and side effects, you may also realize it sooner.

Some people opt to stop taking certain antipsychotics due to severe drowsiness. But this isn’t recommended. Suddenly stopping a medication without working with a doctor can lead to a relapse of symptoms.

If you begin to feel more tired than usual while taking an antipsychotic, consider speaking with your doctor about other options. They may recommend lowering your dosage or switching you to another medication that has a lower chance of causing drowsiness.

They will work with you to determine what’s best for you based on the severity of your symptoms and your response to other therapies.

So … when stopping your medication isn’t an option, how can you fight your severe drowsiness?

Consider trying these tips:

1. Practice good sleep hygiene

Getting a good night’s rest is essential to maintaining mental and physical well-being, but there are a lot of things that make up good sleep hygiene:

  • maintain a regular sleep schedule (try to go to sleep at the same time every night)
  • aim for between 7 and 9 hours of sleep
  • avoid naps during the day
  • avoid stimulants like caffeine, alcohol, and nicotine close to bedtime
  • exercise regularly
  • establish a bedtime routine
  • avoid reading or watching TV in bed
  • try to limit screen use for about an hour before going to sleep

2. Ask about other medications

Some medications have a higher chance of causing drowsiness (somnolence) than others.

Ask your prescriber if you can take an antipsychotic that’s less likely to cause this side effect.

3. Limit other things that make you drowsy

To prevent increasing the drowsiness you’re experiencing, you can limit other substances and medications that also cause drowsiness.

For example, alcohol. This can make you feel even more drowsy.

If you’re unsure what medications could cause increased drowsiness, ask a pharmacist or other healthcare professional.

4. Consider your timing

You may want to rethink the timing of when you take your antipsychotic. For instance, consider taking it at night to lower your daytime drowsiness.

5. Ask about dosing

Ask your treatment team about lowering the dose of your antipsychotic. Higher doses can increase side effects such as drowsiness.

6. Wait it out

When first starting a medication, side effects are more common. You may want to wait at least 2 weeks to build up a tolerance to your med.

After the first 2 weeks, your drowsiness or other side effects should begin to lessen. Just keep your prescriber informed in case it doesn’t.

7. Ask about alternative options

Ask your healthcare team if there are supplements or other meds you can take to manage the drowsiness and help boost your alertness during the day.

A combination of treatments may help fight some side effects, such as drowsiness. And if not, you can always talk with your doctor about tweaking your treatment plan.

If you’re just starting a new antipsychotic medication that may cause drowsiness, try to avoid activities that require alertness — such as driving — until you find out how the med affects you.

In some cases, the drowsiness will go away over time as your body adjusts to the new medication. But if it’s excessive or begins to affect your ability to function during the day, talk with your healthcare team.

Treating mental health conditions often involves some trial and error. Relieving your drowsiness may be as simple as adjusting the dose or switching to a different antipsychotic.

Finding the right combination of treatments can take some time, so give yourself the grace to be patient with the process. Work with your treatment team to find a plan that you can tolerate and works best for you.