Medication is often a part of schizophrenia management, helping relieve symptoms related to psychosis, cognitive impairment, mood, and extrapyramidal symptoms.

Schizophrenia is a lifelong mental health disorder featuring symptoms of altered reality perception known as psychosis.

Hallucination, delusions, and disorganized thinking are hallmark symptoms of this condition, but cognitive impairment, behavioral changes, and functional losses are also possible.

While psychotherapy interventions, psychosocial supports, and life skill programs can help you get back to everyday life after diagnosis, medications are often necessary to help reduce distressing and impairing symptoms.

Your individual schizophrenia medication plan will depend on your symptoms, their severity, and how significantly they affect your daily function.

Your doctor may prescribe medication from a handful of different drug categories, including:

According to a large-scale analysis from 2019, antipsychotics are the most common medications used to treat schizophrenia, followed by anti-anxiety drugs, antidepressants, extrapyramidal drugs, and mood stabilizers.

Antipsychotics

Antipsychotic medications are common in the treatment of schizophrenia. They affect dopamine pathways in your brain, helping to relieve symptoms of psychosis.

Antipsychotics are divided into several types:

First-generation antipsychotics

Also known as “typical” antipsychotics, these were the earliest versions of antipsychotics available, first used in the 1950s. They work primarily on dopamine receptors to reduce positive symptoms of psychosis, such as:

Examples of first-generation antipsychotics used in schizophrenia include:

  • chlorpromazine (Thorazine)
  • fluphenazine (Prolixin)
  • haloperidol (Haldol)
  • perohenazine (Trilafon)

Second-generation antipsychotics

Also known as “atypical” antipsychotics, these medications were the next evolution of antipsychotic development. They work on both dopamine and serotonin receptors in your brain and can be effective for both positive and negative symptoms of schizophrenia.

Negative symptoms refer to experiences of functional loss, such as diminished emotional expression or decreased speech output.

Examples of second-generation antipsychotics used in schizophrenia include:

Long-acting injectables (LAIs)

LAIs are specially formulated antipsychotics that are injected into your body rather than taken in pill form. A single dose can last anywhere from 2 to 24 weeks, making LAIs a good option when taking oral medications consistently isn’t possible.

LAIs used to treat schizophrenia include:

Third-generation antipsychotics

Third-generation antipsychotics are the most recent wave of antipsychotic therapies. They’re often still categorized as second-generation antipsychotics, but because many affect more than dopamine and serotonin, they’re sometimes referred to as “third-generation” or “novel antipsychotics.”

Like other antipsychotics, third-generation drugs work on dopamine networks in the brain, but they also affect novel pathways thought to be involved in schizophrenia pathology, like 5-hydroxytryptamine, glutamate, γ-aminobutyric acid, acetylcholine receptors, and norepinephrine.

Examples of third-generation antipsychotics include:

  • lurasidone (Latuda)
  • lumateprone (Caplyta)
  • SEP-363856 (currently in research)
  • pomaglumetad mmethionil (currently in research)

Do people with schizophrenia have to take medication for life?

Schizophrenia is a lifelong condition. Most people successfully manage symptoms by remaining on medications indefinitely.

This is not a sign of weakness in those with schizophrenia — many physical conditions, like asthma, also require lifelong medication plans.

For some, symptoms may improve enough that medications can be decreased or stopped completely for periods of time or all together. But there’s no way to know at the time of diagnosis if this will be possible.

Antidepressants

Antidepressants are medications that work by regulating levels of certain neurotransmitters in your brain that affect mood.

While these drugs are used with caution in schizophrenia because they may worsen psychotic symptoms in some people, research from 2023 suggests they may offer important quality-of-life benefits in schizophrenia.

Types of antidepressants include:

Mood stabilizers

Mood stabilizers also affect neurotransmitters in your brain that contribute to mood symptoms. They’re used in schizophrenia when other therapies aren’t as successful in managing mood-related symptoms.

Common mood stabilizers include:

Anti-anxiety drugs

Anti-anxiety drugs help relieve symptoms of anxiety and agitation by targeting specific neurotransmitter pathways in your brain.

Common types of anti-anxiety drugs used in schizophrenia include:

Extrapyramidal drugs

Extrapyramidal symptoms (EPS) are movement disorder side-effects of antipsychotic medications. If these symptoms develop, your doctor may prescribe medications such as:

Each individual medication and class of medications used to treat schizophrenia comes with its own list of potential side effects and warnings.

Common possible side effects by medication category for schizophrenia include:

Antipsychotics

  • EPS (more common with first-generation antipsychotics)
  • sedation
  • dry mouth
  • constipation
  • vision changes
  • blood pressure drop upon standing
  • weight gain (more common in second-generation antipsychotics)

Antidepressants

Mood stabilizers

Anti-anxiety drugs

Extrapyramidal drugs

Your doctor will go over specific precautions and recommendations for each medication you’re taking.

Some may not be suitable if you’re living with co-occurring conditions, may need to be taken with food, or might not be as effective with certain dietary habits. Vitamin supplements or drinks high in vitamin C, for example, may alter or negate the effects of schizophrenia medications like antipsychotics.

While your doctor will explain your individual safety measures, you can help reduce your overall risk for adverse medication reactions by:

  • discuss all your medications, supplements, or vitamins with your doctor
  • understanding what each of your medications is for
  • discuss your general diet with your doctor
  • taking all medications exactly as directed
  • monitoring closely for side effects (creating a symptom journal can help with this)
  • communicating regularly with your doctor about symptom changes
  • eliminating recreational drug and alcohol use
  • attending regularly scheduled therapy appointments
  • setting up reminders or other ways of sticking to your treatment plan

Medications don’t directly cause schizophrenia, but they may promote symptoms of psychosis that affect the development of schizophrenia in people predisposed to the condition.

Drug-induced psychosis is a mental health condition where substance use leads to psychotic symptoms. When drug-induced psychosis symptoms persist even after substance use ends, it may be diagnosed as drug-induced schizophrenia.

According to a systematic review and meta-analysis from 2020, illegal drugs like amphetamines and hallucinogens are the most likely to lead to drug-induced schizophrenia; however, the condition can also be brought on by prescription medications such as:

Schizophrenia medications vary in type and purpose. While many people are prescribed antipsychotics, your individual treatment plan may also involve antidepressants, mood stabilizers, or medications to manage extrapyramidal symptoms — among many others.

Understanding your medications’ purposes, how to safely take them, and what side effects to watch for can help reduce your risk for adverse reactions.