Plain-language guides to the antipsychotic medications used to treat schizophrenia, sourced from FDA labeling.
Risperidone is generally well tolerated at low doses, but has a distinctive side effect profile — particularly hyperprolactinaemia and dose-dependent movement effects. Here's what to expect and how to handle them.
Lab monitoringAntipsychotics can change cholesterol and triglyceride levels in just a few months. Lipid monitoring catches the shifts before they become heart disease.
MedicationDroperidol is a fast-acting butyrophenone used in emergency rooms for severe agitation and as a powerful antiemetic. Its regulatory history is one of the most contentious in modern psychiatry.
MedicationMolindone is a first-generation antipsychotic with one unusual property — it tends to cause weight loss rather than weight gain. It also faded from market availability for several years, then returned. Here is its story.
InteractionsOpioids and antipsychotics are increasingly co-prescribed. The combination is not categorically wrong but the additive risks — sedation, respiratory depression, constipation, QT — deserve real attention.
MedicationAbilify Maintena delivers a month of aripiprazole in one injection — an LAI option for patients who tolerate aripiprazole well and want monthly dosing for adherence support.
Medication managementA stomach bug or a bad case of flu can interrupt a stable medication routine. Here is how to handle it without destabilizing weeks of psychiatric stability.
Drug interactionsAcetaminophen — Tylenol or paracetamol — is one of the most common over-the-counter medications and is generally safe to combine with antipsychotics. The nuances mostly involve dose limits and liver health.
MedicationMesoridazine, sold as Serentil, was an active metabolite of thioridazine marketed as an antipsychotic in its own right. It was discontinued in the US in 2004 because of QT prolongation concerns.
TreatmentAfter 70 years of dopamine-blocking antipsychotics, Cobenfy works differently — through muscarinic acetylcholine receptors. The trial results are real, but so are the side effects.
MedicationSwitching antipsychotics is common and sometimes essential — but it's also where most relapses happen. Here's how to recognise when it's worth doing and how a safe cross-taper works in practice.
MedicationMesoridazine, an active metabolite of thioridazine, followed its parent drug into the margins of practice for the same cardiac reason. Its short history is a useful case study.
Women's healthMost antipsychotics are compatible with breastfeeding to some degree. Here is what's known, what to watch for, and how the decision usually gets made.
MedicationOlanzapine works exceptionally well for many people but is one of the heaviest weight-gain antipsychotics. Lybalvi combines it with an opioid receptor blocker designed to soften that side effect.
LAIInjection-site soreness is the most common everyday side effect of long-acting injectable antipsychotics. Here's a practical guide to managing pain, what's normal, and what to flag.
MedicationAmantadine sidesteps the cognitive and bowel costs of anticholinergics, making it a useful option for some patients with antipsychotic-induced parkinsonism — but it has its own set of trade-offs.
MedicationRisperdal Consta was the first long-acting injectable atypical antipsychotic — given every two weeks. It still has a role, though newer LAIs have largely replaced it for new starts.
Lab monitoringSeveral antipsychotics raise the risk of type 2 diabetes — sometimes within weeks. Routine glucose and A1c monitoring catches the changes early, while interventions still work well.
MedicationFluphenazine is one of the original high-potency phenothiazines and one of the first antipsychotics formulated as a long-acting depot injection. Both forms remain in use.
MedicationCariprazine has the longest half-life of any oral antipsychotic, which shapes everything from akathisia onset to how dose changes feel. Here's the practical guide.
MedicationCariprazine is a D3-preferring partial agonist with an unusually long half-life. The pharmacology shapes how it feels, how slowly it works, and how slowly it leaves the system.
Medication managementSurgery is stressful enough without losing track of psychiatric medication. Here is how patients and prescribers plan around the operating room.
Drug interactionsCannabis interacts with antipsychotics in several layered ways — through liver enzyme induction, through additive sedation and cognitive effects, and through worsening of psychotic symptoms.
MedicationAristada is a long-acting aripiprazole prodrug with multiple dosing intervals — from every month to every 8 weeks — and a separate Aristada Initio form that can shorten the oral overlap to a single day.
Women's healthPostpartum psychosis affects roughly 1 to 2 in 1,000 births and is a true psychiatric emergency. Recognising it early changes outcomes for the parent and the baby.
MedicationTrifluoperazine, sold as Stelazine, is a piperazine phenothiazine — chemically a cousin of fluphenazine, with similar high-potency D2 blockade and a long clinical track record.
MedicationPimavanserin is unique: it acts only on serotonin receptors, with no dopamine blockade at all. FDA-approved for Parkinson's psychosis, its role in schizophrenia-spectrum care is more limited and worth understanding clearly.
MedicationTrihexyphenidyl is a centrally acting anticholinergic introduced in the late 1940s. It can be very useful for movement side effects, but the long-term cognitive cost matters.
MedicationAsenapine's distinctive sublingual delivery brings its signature side effect: a numb mouth that some patients tolerate easily and others can't. Here's what else to expect.
Medication managementStopping or reducing an antipsychotic can produce three distinct things — discontinuation symptoms, rebound psychosis, and withdrawal dyskinesia. Telling them apart matters.