Schizophrenia - Treatment

Highlights	Complications	Resources
Introduction	Diagnosis	References
Symptoms	Treatment	References
Causes	Medications
Risk Factors	Psychotherapy

Medications

Atypical Antipsychotic Drugs

Ten atypical antipsychotic drugs are currently approved in the United States:

Clozapine (Clozaril, generic)
Risperidone (Risperdal, generic)
Olanzapine (Zyprexa)
Quetiapine (Seroquel)
Aripiprazole (Abilify)
Ziprasidone (Geodon)
Paliperidone (Invega)
Iloperidone (Fanapt)
Asenapine (Saphris)
Lurasidone (Latuda)

Clozapine was the first atypical drug approved (in 1989), and lurasidone the most recently approved (in 2010). Clozapine and olanzapine appear to have more side effects than the other atypical antipsychotics, particularly in terms of causing weight gain, insulin resistance, and unhealthy cholesterol levels. For this reason, many doctors recommend against using clozapine or olanzapine as first-line drugs. However, clozapine may have specific benefits for controlling positive symptoms, as well as violent, hostile, or suicidal behaviors.

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Most atypical antipsychotics come in pill form, but some may come in liquid form or as an injection. In general, it may take up to 6 months before an atypical drug has an effect.

The atypical antipsychotics zotepine (Zoleptil) and amisulpride (Solian) are not approved for use in the United States.

Benefits of Atypical Antipsychotics.

Affect both dopamine receptors and other neurotransmitters responsible for psychotic symptoms
Improve negative and positive symptoms
May improve working memory and mental functioning
May reduce depression and hostility
May reduce the risk for suicide
Have fewer extrapyramidal side effects than the typical antipsychotics (see "Extrapyramidal Symptoms" below)

Atypical antipsychotics have some significant limitations and complications, and their benefits compared to each other and to other antipsychotics are not always clear-cut.

Side Effects of Atypical Antipsychotics.