Understanding Antipsychotic Medications

What are antipsychotics used for?

Antipsychotic medications are used to treat schizophrenia, schizoaffective disorder, bipolar disorder (particularly during mania or with psychotic features), and some other conditions involving hallucinations, delusions or severe agitation. Second-generation (atypical) antipsychotics are generally preferred first-line, given a more favorable side-effect profile regarding movement symptoms.

What to expect

• Some sedation or calming effect can occur within days; full effect on hallucinations or delusions usually takes several weeks
• Your psychiatrist will start at a low dose and adjust gradually
• Regular follow-up appointments are needed to monitor response and side effects
• Long-acting injectable forms are available for some antipsychotics if adherence to daily tablets is difficult

Common side effects

• Sedation or drowsiness, especially early in treatment
• Weight gain and changes in blood sugar or cholesterol — regular monitoring is important
• Movement-related effects: stiffness, tremor, restlessness (report these to your psychiatrist)
• Dry mouth, constipation, or mild dizziness on standing

Physical health monitoring

• Weight, blood pressure and waist circumference checked regularly
• Blood sugar (glucose) and cholesterol (lipid) testing periodically
• For clozapine specifically, regular blood tests are required to monitor white blood cell count

Important safety notes

• Do not stop abruptly without medical guidance — stopping suddenly increases relapse risk
• Report severe muscle stiffness, high fever or confusion immediately (possible Neuroleptic Malignant Syndrome — a medical emergency)
• Discuss alcohol use and other medications with your psychiatrist