First-Generation Antipsychotics for Treating Schizophrenia
These medicines are available as tablets, a concentrated liquid, or an injection (shot). Long-acting formulas that are given every 2 to 4 weeks are available for fluphenazine and haloperidol.
How It Works
Experts don't know exactly how these antipsychotic medicines work. They think these medicines work because of how they affect brain chemicals (neurotransmitters). They usually are started at low doses to avoid side effects.
Why It Is Used
First-generation antipsychotics are used to reduce anxiety and agitation that often happen in schizophrenia. They can also reduce problems with thinking or remembering (cognitive impairment) and reduce or control delusions and hallucinations (psychosis).
How Well It Works
First-generation antipsychotics can reduce or control psychosis and improve thinking, mood, and behavior. These medicines may help you return to a more normal daily life while living with schizophrenia.
First-generation antipsychotics may work differently in different people. For some people, these medicines may help with many symptoms, while other people may have to try other antipsychotic medicines to find the one that works best for them.
First-generation antipsychotic medicines can cause mild to severe problems with body movements.
Other serious side effects include:
Other common, mild side effects include:
First-generation antipsychotics may raise levels of the hormone prolactin. This can lead to breast enlargement in both men and women and abnormal menstrual cycles in women.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
If you have any significant side effects while taking an antipsychotic, call your doctor right away. You may need another type of medicine, or the dose may need to be lowered.
There is some evidence of a link between first-generation antipsychotics (such as haloperidol or thioridazine) and an increase in cardiac arrest (heart stopping) or abnormal heartbeat.1 But it is not yet clear whether the risk is linked with the medicines or with schizophrenia.
If you have trouble taking antipsychotic medicines every day, you may be able to get a shot every 2 to 4 weeks. Talk with your doctor about whether this would be better for you.
You most likely will start by taking only a little of the medicine and then slowly take more. It may take several weeks before you know the medicine is working and know the best dose. If you do not see any benefits within 6 weeks, ask your doctor if you need to try another type of medicine.
Do not abruptly stop taking these medicines. Do not skip doses. If you forget to take a dose, take it as soon as you remember, but do not take more than one dose at a time.
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 for you in the past and its side effects. Your doctor will help you find the best medicine for you.
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