These medicines are available as tablets or injection
Risperdal Consta is given as a shot by a doctor every 2
weeks. Because a doctor gives the shot and it lasts longer than other
medicines, some experts think this makes it more likely that a person will take
enough medicine to get better.
Experts don't know exactly how these
antipsychotic medicines work. They think these medicines work because of how
they affect brain chemicals (neurotransmitters).
These medicines treat the symptoms of
schizophrenia. They may also cause fewer movement side
first-generation antipsychotic medicines, such as
haloperidol (Haldol) or chlorpromazine.
Because they may have
fewer side effects, second-generation antipsychotics often are used first when
a person is first diagnosed with schizophrenia. But some doctors feel that
first-generation antipsychotics started at low doses may work just as well and
at a lower cost.
These medicines reduce or eliminate
the positive symptoms (such as
delusions) and sometimes help reduce the
negative symptoms (such as lack of emotion or
motivation) of schizophrenia.
also may help reduce the risk of movement disorder side effects (such as
The side effects of the new
second-generation antipsychotic medicines vary.
Side effects that
all these medicines may have include:
The makers of Risperdal, Seroquel, and Zyprexa have warned
that high blood sugar or
type 2 diabetes may be more likely in people who are
taking these medicines.
Among second-generation antipsychotic
medicines with other side effects:
In rare cases, second-generation antipsychotic medicines
can cause some people to develop
neuroleptic malignant syndrome. This is a rare but
life-threatening side effect of antipsychotics. The first signs usually include
a fever between 102°F (38.9°C)
and 103°F (39.4°C), a fast or
irregular heartbeat, rapid breathing, and severe sweating.
some instances, these medicines may cause body movements you can't control,
tardive dyskinesia. This side effect may be more
likely when taking first-generation antipsychotic medicines.
Drug Reference for a full list of side effects. (Drug Reference is not
available in all systems.)
The first-generation and
second-generation antipsychotic medicines both can help the symptoms of
schizophrenia. Which medicine is best for you usually depends on how well a
medicine has worked in the past and its side effects. Your doctor will help you
find the best medicine for you.
The effects of the
second-generation antipsychotic medicines have not been studied in children,
older adults, or pregnant women.
If one antipsychotic medicine does
not reduce or eliminate the symptoms of schizophrenia, your doctor may add
another medicine or change to a different antipsychotic medicine.
How much medicine a person needs to treat schizophrenia varies for each
person and with each medicine. If you take mood-stabilizing medicines along
with antipsychotics, you may not have to take as much of the antipsychotic
medicine. This will help reduce side effects.
Always take your
medicine as directed by your doctor. Store it away from heat or light, and do
not store it in the kitchen or bathroom, where heat and moisture may cause it
to lose its strength.
If you miss a dose of medicine, take it as
soon as you remember. But if it is close to the time of your next dose, skip
the missed dose and continue to take the medicine according to schedule. Do not
take double doses. Call your doctor if you have any questions
about missed doses. Do not stop taking these medicines without telling your
Both first-generation and
second-generation antipsychotic medicines may make a stroke more likely in
older adults who have dementia.2
Sometimes people who have schizophrenia also
need to take medicines for other illnesses. Other medicines may interact with
medicines for schizophrenia. Talk to your doctor if you are taking other
People who have certain body movement disorders (such as
Parkinson's disease or
seizures) or liver disease may not be able take
risperidone. Tell your doctor if you have any other health problems.
Talk to your doctor if you drink alcohol.
second-generation antipsychotic medicines may pass into breast milk and cause
problems in a baby, including behavior changes. Talk with your doctor about
this if you are breast-feeding.
To reduce interactions, ziprasidone
should not be taken with certain medicines, such as amiodarone (Cordarone) or
Ziprasidone can slow down the
heart, so do not take it with other medicines that also do this, and do not take
it if you have heart problems. While you are taking ziprasidone, your doctor
may suggest that you get an
electrocardiogram (EKG, ECG) to measure your heart's
Because ziprasidone does not cause a lot of
weight gain, it may be a good choice for people with schizophrenia who also
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
CitationsDurham J (2009). Schizophrenia: A review of pharmacologic and nonpharmacologic treatments. US Pharmacist, 34(11): 1–5.Douglas IJ, Smeeth L (2008). Exposure to antipsychotics and risk of stroke: Self-controlled case series study. BMJ. Published online August 28, 2008 (doi:10.1136/bmj.a1227).
August 16, 2011
Kathleen Romito, MD - Family Medicine & Miklos Ferenc Losonczy, MD, PhD - Psychiatry
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