Medication for schizophrenia

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The treatment with medication consists of antipsychotic drugs. The antipsychotic drugs initially bring the acute psychosis under control and thereafter, prevent further episodes from occurring.

Medications that have been used regularly in the past include haloperidol and chlorpromazine.

While these older medications are effective in treating the positive symptoms, they are less successful in addressing the negative symptoms. They also have undesirable side effects. These include uncontrollable movements, tremors, lethargy, blunted emotions, shuffling gait and staring eyes.

Using the correct dosage and taking the medication regularly can minimise the side effects. Additional medication can also be prescribed to offset certain side effects.

More recently however, there has been a development in so called "new generation" antipsychotic drugs. These drugs seem to be more effective in reducing social isolation and withdrawal of patients and have been proven to cause significantly fewer movement side effects than their predecessors. 

They include Risperidone, Quetiapine, Olanzapine, Aripiprazole, Amisulpride, Paliperidone, Ziprasidone and Clozapine. 

Although they are more expensive, this is offset by their improved efficacy, which means less hospitalisation and better functioning of the individual. There are, however, still some problematic side effects with the newer medications, including weight gain and a change in glucose and lipid metabolism. 

Research continues to produce better medications with fewer side effects and researchers hope that they will be able to treat the disorder more successfully in the future. 

In addition to antipsychotic drugs, people with schizophrenia can also take Omega 3 fatty acids (fish oils) as these have been shown to improve the outcome of the illness.

Reviewed by Dr Tasneem Mahomed, MBBCh (Wits), FC Psych (SA), Mmed Psych (Wits),
Psychiatrist in private practice, Cape Town. March 2015.

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