Schizophrenia medications & treatments
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Schizophrenia is a fairly uncommon mental health condition that affects less than 1% of the U.S. population, according to the National Institute of Mental Health (NIMH). Men often develop schizophrenia symptoms in their late teens or early 20s, while women develop them in their late 20s and early 30s. It is uncommon to be diagnosed with schizophrenia if you are younger than 12 or older than 40.
What is schizophrenia?
Schizophrenia is a chronic psychotic disorder that affects how you think, feel and behave. People with this mental disorder often experience distortions of reality (psychosis) in the form of delusions or hallucinations. Schizophrenia requires lifelong treatment. Early diagnosis and treatment are keys to preventing complications and improving your long-term outlook.
Although the exact cause of schizophrenia is not known, certain risk factors can increase the chance of developing schizophrenia, including:
- Genetics. Your risk of developing schizophrenia is 6 times higher if you have a family member such as a parent or sibling, with this condition.
- Brain chemistry. Problems with brain chemicals, including neurotransmitters dopamine and serotonin can cause an increased risk of schizophrenia.
- Brain structure. Research shows that people with this condition may have differences in the size of certain brain areas. Some of these size differences may develop before birth.
- Environmental factors. Viral infections or malnutrition before birth, particularly in the first and second trimesters have been shown to increase the risk. Some other pregnancy complications that can increase the risk of schizophrenia include gestational diabetes, preeclampsia, and emergency cesarean section.
- Substance abuse. Studies suggest that taking mind-altering drugs during teen years and young adulthood increases your risk of schizophrenia. It is also thought that smoking cannabis can increase your risk.
How is schizophrenia diagnosed?
For a diagnosis of schizophrenia, your doctor or mental health professional may look at your symptoms, review your medical and family history, perform a physical exam, and run some blood or imaging tests.
The common symptoms of schizophrenia can typically fall into the following 3 categories:
- Positive symptoms. You may suffer from psychotic symptoms, including hallucinations (hearing voices or seeing things that are not there). You may also have paranoia and distorted perceptions, beliefs, and behaviors.
- Negative symptoms. These symptoms include a lack of motivation to make plans, express emotion, or find pleasure.
- Disorganized/Cognitive symptoms. Cognitive deficits, including memory loss and disorganized thinking and speech, may be present.
Most doctors use the criteria from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to confirm a schizophrenia diagnosis. To meet the criteria for diagnosis of schizophrenia, 2 or more of the following symptoms must be significantly present during a 1 month period:
- Disorganized speech
- Grossly disorganized or catatonic behavior
- Negative symptoms.
At least one of the symptoms must be delusions, hallucinations, or disorganized speech. There must also be social and work dysfunction for at least six months.
What are some schizophrenia treatment options?
Schizophrenia is a lifelong condition, but with medications and therapy, you can reduce the severity and frequency of symptoms and avoid hospitalization.
Antipsychotic medication is the most common treatment to help reduce hallucinations and delusions.
- First-generation antipsychotics (typical antipsychotics). These medications cause more neurological side effects than newer antipsychotics. Examples include Haldol (haloperidol), Prolixin (fluphenazine), and Trilafon (perphenazine).
- Second-generation antipsychotics (atypical antipsychotics). These medications are typically the initial treatment for schizophrenia due to their increased effectiveness and lower risk of side effects. They include Abilify (aripiprazole), Seroquel (quetiapine), Zyprexa (olanzapine), and Latuda (lurasidone hydrochloride).
Psychotherapy intervention, including individual therapy, can help you cope with stress and your condition. It can also improve your social and communication skills. These may include:
- Cognitive behavioral therapy (CBT). CBT studies have shown it to be an effective treatment for a wide variety of mental illnesses, including schizophrenia. It focuses on the management of psychotic episodes and dealing with how your unhealthy thought patterns may be causing self-destructive behaviors. CBT may actually improve your brain functioning as well.
- Cognitive enhancement therapy (CET). This therapy involves a combination of computer-based brain training and group sessions to help you organize your thoughts and improve concentration.
- Rehabilitation. If you suffer from schizophrenia, you could benefit from support groups and psychosocial treatment plans to help develop life-management skills and keep a job.
- Electroconvulsive therapy. If you do not respond to antipsychotic drug therapy, your doctor may recommend ECT. It is typically reserved for very severe cases and it can be lifesaving in people who are at high risk of suicide.
What is the best medication for schizophrenia?
The best medication for the treatment of schizophrenia will depend on the individual’s specific medical schizophrenia, medical history, medications that the individual is already taking that may potentially interact with schizophrenia medications, and the individual’s potential response to the treatment. It is advisable to always speak with your healthcare provider about the best medication for you. The table below includes a list of the most prescribed or over-the-counter schizophrenia medications approved by the Food and Drug Administration (FDA).
Best medications for schizophrenia
|Drug name||Drug class||Administration route||Standard dosage||Common side effects|
|Haldol (haloperidol)||Antipsychotic||Oral||0.5mg to 5mg every 8 to 12 hours. Max of 30mg/day.||Fatigue, drowsiness, weight gain, erectile dysfunction|
|Prolixin (fluphenazine)||Antipsychotic||Oral||1mg to 5mg every 6 to 8 hours. Max of 40mg/day.||Fatigue, drowsiness, weight gain, erectile dysfunction|
|Navane (thiothixene)||Antipsychotic||Oral||20mg to 60mg per day divided every 8 to 12 hours.||Fatigue, drowsiness, weight gain, erectile dysfunction, headache|
|Trilafon (perphenazine)||Antipsychotic||Oral||4mg to 8mg every 8 hours.||Restlessness, confusion, fatigue, weight gain|
|Thorazine (chlorpromazine)||Antipsychotic||Oral||200mg per day divided every 6 to 12 hours.||Fatigue, drowsiness, weight gain, erectile dysfunction|
|Latuda (lurasidone)||Antipsychotic||Oral||40mg to 160mg once daily.||Drowsiness, restlessness, high blood sugar, nausea, insomnia|
|Abilify (aripiprazole)||Antipsychotic||Oral||10mg to 30mg once daily.||Weight gain, headache, agitation, insomnia, anxiety, nausea, vomiting|
|Geodon (ziprasidone)||Antipsychotic||Oral||20mg to 80mg every 12 hours.||Drowsiness, headache, nausea, dizziness, restlessness|
|Invega (paliperidone palmitate)||Antipsychotic||Oral||6mg to 12mg every morning.||Tremors, muscle stiffness, restlessness, involuntary facial movements, headache, drowsiness|
|Invega Sustenna (paliperidone palmitate)||Antipsychotic||Oral||6mg to 12mg every morning.||Injection site reaction, tremors, weight gain, headache, muscle stiffness|
|Fanapt (iloperidone)||Antipsychotic||Oral||1mg to 12mg every 12 hours.||Dizziness, dry mouth, nausea, drowsiness, fast heart rate, weight gain|
|Zyprexa (olanzapine)||Antipsychotic||Oral||5mg to 20mg once daily.||Weight gain, drowsiness, dry mouth, tremors, restlessness, weakness, dizziness|
|Seroquel (quetiapine)||Antipsychotic||Oral||150mg to 750mg per day divided every 8 to 12 hours.||Dizziness, fatigue, increased appetite, constipation, dry mouth, headache|
|Risperdal (risperidone)||Antipsychotic||Oral||2mg to 8mg once daily or divided every 12 hours.||Drowsiness, insomnia, agitation, anxiety, headache|
|Saphris (asenapine)||Antipsychotic||Sublingual||Dissolve 5mg to 10mg under the tongue every 12 hours.||Drowsiness, headache, dizziness, insomnia, weight gain, tremor, muscle stiffness|
|Vraylar (cariprazine)||Antipsychotic||Oral||1.5mg to 6mg once daily.||Restlessness, involuntary facial movements, headache, insomnia, constipation, nausea|
|Clozaril (clozapine)||Antipsychotic||Oral||300mg to 900mg per day divided every 12 hours.||Drooling, drowsiness, weight gain, dizziness, increased heart rate, insomnia|
|Lyvalvi (olanzapine/samidorphan)||Antipsychotic||Oral||5mg/10mg to 20mg/10mg once daily.||High blood sugar, weight gain, drowsiness, increased appetite, dry mouth, headache|
Your healthcare provider will determine the right dosage based on your response to the treatment, medical condition, weight, and age. Other possible side effects may exist; this is not a complete list.
What are the most common side effects of schizophrenia medications?
As with all medicines, those used for schizophrenia will have some side effects, depending on the class you are taking. Some of the most common side effects of these antipsychotic medications include:
- Extrapyramidal side effects include involuntary muscle and facial movements (tardive dyskinesia), tremors, restlessness, and muscle stiffness.
- Weight gain
- Dry mouth
- High blood pressure
- Increased heart rate
What are some home remedies for schizophrenia?
While medications and physical therapy are important in the treatment of schizophrenia, there are some lifestyle changes and self-care measures you can do to help manage your condition.
A significant number of people with schizophrenia die from heart disease. Increasing your physical activity, eating healthier, and stopping smoking can decrease your risk of dying. It can also help with the emotional and physical effects of schizophrenia.
Frequently asked questions about schizophrenia
Who gets schizophrenia?
Schizophrenia is a serious mental illness that affects less than 1% of the U.S. population. Men tend to develop schizophrenia symptoms earlier than women. A combination of genetics, brain chemistry, brain structure, and environmental factors all play a part in the development of schizophrenia.
What are some complications of schizophrenia?
Complications that may be associated with schizophrenia include:
- Suicidal thoughts or attempts
- Anxiety disorders
- Obsessive-compulsive disorder (OCD)
- Substance use
- Inability to work or attend school
- Social withdrawal
- Financial problems and homelessness
What is the life expectancy of someone with schizophrenia?
If you have schizophrenia, your life expectancy is about 15 years less than those who do not have this condition.
How can I help a friend or loved one with schizophrenia?
It is difficult to know how to help someone you love who has schizophrenia. Some things you can do include:
- Help them find treatment and encourage them to stay in it.
- Do not discount their beliefs or hallucinations. They seem very real to them.
- Be supportive without tolerating dangerous or inappropriate behavior.
- Educate yourself on this disorder. The National Alliance on Mental Illness has some helpful resources.
If your loved one is thinking about, harming themselves or others, seek help right away:
- Call 911.
- Call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text the Crisis Text Line (text HELLO to 741741).
What is the difference between schizophrenia and schizoaffective disorder?
With schizophrenia, you may hear voices and see things that don’t exist. Schizoaffective disorder is a blend of the symptoms of schizophrenia and bipolar disorder. You feel detached from reality and have mood swings that include depression and mania.
Related resources for schizophrenia
- What is schizophrenia? Psychiatry.org
- Schizophrenia practice essentials. Medscape
- Schizophrenia overview. MayoClinic
- Schizophrenia treatment and support. National Alliance on Mental Illness
- Schizophrenia: an overview. WebMD