Schizophrenia Drugs: The Older Atypicals

  • This SharePost is the second in a series devoted to schizophrenia treatment and it focuses specifically on some of the atypical drugs used to control the symptoms of this illness.


    Disclaimer: This information is for educational purposes only.  Speak to your psychiatrist for any medical advice you have concerning a particular drug.  Taken from the prescribing information with links to the drug Web sites at the end of this article.  Not every side effect or detail about the drug is described here.

    As with all SZ drugs, the risks should be weighed against the benefits in making any decision about which drug to take.  All the drugs cited are used to treat the positive symptoms of schizophrenia like delusions, hallucinations (hearing voices or seeing things) and paranoia.

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    Risperdal or risperidone is a tablet that comes in 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, and 4 mg strengths.  It can be taken with or without food.  It is administered once or twice daily.


    Side effects include somnolence, increased appetite, fatigue, insomnia, sedation, parkinsonism, akathisia, vomiting, cough, constipation, nasopharyngitis, drooling,

    rhinorrhea, dry mouth, abdominal pain upper, dizziness, nausea, anxiety,

    headache, nasal congestion, rhinitis, tremor, and rash.


    The side effect of increased appetite can cause weight gain.  Anecdotal stories suggest short-term memory loss in some people taking this drug.  It is available in injectable form as RisperdalConsta.


    It can be used in adolescents aged 13 to 17.  Nursing mothers should not breast feed while on this drug. 


    Zyprexa has had such a notorious career as an infamous SZ drug that Eli Lilly has taken down its Web site and is updating the content.  It is one of the biggest culprits along with Clozaril in causing weight gain of upwards of 100 lbs.  Seriously.  This is not unheard of.  Class actions lawsuits involving Zyprexa cite the likelihood of developing diabetes while on this drug, due to the side effect of an increase in high blood sugar.

    However: for some people with schizophrenia it is the only drug that effectively halts their positive symptoms.  A drug like Geodon is sometimes considered a light drug because it doesn't always help people whose symptoms are more severe.


    So Zyprexa was often the drug of choice in treating a lot of people's symptoms.


    It is available in strengths of 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg and 20 mg. It is available as a wafer called Zydis that dissolves on the tongue, in strengths of 5 mg, 10 mg, 15 mg and 20 mg.  It is taken once a day with or without food.


    Children who are at least 13 years old can take Zyprexa.  Avoid breast feeding while on this drug.


    Seroquel or Quetiapine Fumarate is available in 25 mg, 50 mg, 100 mg, 200 mg, 300 mg, and 400 mg tablets.


    Side effects include dry mouth, somnolence, weight gain, agitation, dizziness, constipation and vomiting.


    It can be used in adolescents aged 13 to 17 years.  Breast feeding while on Seroquel is discouraged as it can be found in breast milk.


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    Clozaril or Clozapine is the treatment of choice for refractory schizophrenia.  It often works when people haven't found relief with numerous other drugs, yet like the other treatments it can cause weight gain.


    People taking this drug must get monthly blood tests as Clozaril has a side effect of agranulocytosis, a potentially fatal blood disorder.  A side effect, especially during the first month of therapy and also with ongoing therapy, could be fatal myocarditis.  Treatment with Clozaril should be discontinued if myocarditis is suspected.


    It can elevate blood sugar and thus like the other drugs cause diabetes. 


    It is available in pale yellow tablets of 25 mg and 100 mg.


    It produces little or no prolactin elevation, unlike the other drugs that do.  Like with the other drugs, avoid breast feeding while on Clozaril.


    Women taking any of these drugs, or any of the atypicals for that matter, are advised to consult their psychiatrist if they plan to get pregnant as there are risks to the fetus.

    I will devote the next SharePost to SZ drugs being researched and the status of the latest research.










Published On: August 14, 2011