Schizophrenia Medication Side Effects: What To Expect and How To Cope

Schizophrenia medications can be life-changing if you’re living with schizophrenia. They can help you manage your symptoms, reduce episodes of illness, and make your life more stable. However, like all medications, schizophrenia medications can cause side effects — an unwanted or unintended effect of a medication.

The side effects of schizophrenia medications can differ greatly from person to person. Whether you’re already taking a schizophrenia medication or weighing your treatment options, you may have questions about possible side effects and how to cope. With the right support, many people can find a schizophrenia treatment plan that works for them.

Why Do Schizophrenia Medications Cause Side Effects?

To understand why schizophrenia medications can cause side effects, you should learn more about how they work.

Antipsychotic medications are the most common type of medication to treat schizophrenia. These medications work by balancing chemicals in your brain, called neurotransmitters. Different types of antipsychotics affect different neurotransmitters. First-generation antipsychotics tend to affect neurotransmitters like dopamine, acetylcholine, histamine, and norepinephrine. Second-generation antipsychotics typically affect neurotransmitters like dopamine and serotonin.

Affecting these neurotransmitters can help improve the symptoms of psychosis (such as hallucinations and delusions). However, these chemicals are also involved in other processes in your body. When an antipsychotic medication changes the balance of neurotransmitters, it can have unintended effects on the body, causing side effects.

What Are the Side Effects of Antipsychotics?

Antipsychotic side effects range from mild to severe. Each antipsychotic drug has its own unique set of side effects that affect each individual differently. That means it’s hard to know exactly what side effects you’ll experience when you start a new antipsychotic medication.

Dr. Robert Channon, a board-certified psychiatrist with more than 40 years of experience treating people with severe mental illness in Chicago, cautioned that, “Unfortunately, side effects often precede benefits.”

Some side effects can start shortly after you start a new medication, while the benefits to your symptoms can take longer. That’s why it’s important not to stop your medication without discussing it with your healthcare provider, even if you’re not sure it’s working.

The list of potential antipsychotic side effects may look long, but it’s important to know that not everyone gets every side effect. If you know what side effects to expect, you’ll be better prepared to manage them and know when to reach out for support. Potential side effects of antipsychotic medications may include:

• Weight gain
• Increased appetite
• High blood sugar
• High cholesterol
• Dizziness
• Anxiety
• Temperature sensitivity
• Restlessness
• Abnormal movements
• Constipation
• Dry mouth
• Blurry vision
• Difficulty urinating
• Drowsiness
• Heart problems
• Orthostatic hypotension (low blood pressure and dizziness when standing)
• Hormone changes
• Liver problems
• Sun sensitivity

Some side effects, like orthostatic hypotension and drowsiness, can get better after you’ve been on the medication for some time. Other side effects, like weight gain or dry mouth, may or may not change over time.

This isn’t a complete list of all the possible antipsychotic side effects. Talk to your healthcare provider about the likelihood of side effects for the specific medication you’re taking.

Rare but Serious Side Effects

Dr. Channon warned about two kinds of side effects: “The side effects that are a nuisance, and they can be enough of a nuisance that you don’t want to take the medicine, versus side effects that are dangerous, even if they’re not a nuisance.”

Some serious side effects may not cause any symptoms even though they’re more dangerous. For example, some antipsychotic medications can cause heart rhythm problems, which may not have any noticeable symptoms.

Blood Disorders

Blood disorders are another serious side effect, especially with first-generation antipsychotics and some second-generation antipsychotics, like clozapine (sold by the brand names Clozaril and Versacloz). One rare but dangerous condition is agranulocytosis, where the body stops making enough white blood cells. If you have agranulocytosis, your immune system has a hard time fighting off illness.

Some antipsychotics can also affect how your blood clots, making you more likely to develop a blood clot. Regular blood tests and following up with your healthcare provider are important to catch these issues early if you’re taking these medications.

Neuroleptic Malignant Syndrome

Neuroleptic malignant syndrome (NMS) is a rare but serious side effect that can happen at any time while you’re taking an antipsychotic medication. NMS can also happen when you stop taking an antipsychotic. People who develop NMS usually notice symptoms like fever, stiff muscles, and confusion that develop quickly over one to three days. If you notice these symptoms, it’s important to seek medical care right away.

Coping With Common Side Effects

Dealing with side effects can be challenging, but there are things you can do to make your treatment easier. Be open and honest about your side effects with your healthcare team. Keeping track of your symptoms can help you and your provider understand what helps you feel better and what might be causing problems.

Dr. Channon shared, “While there are side effects, in most cases, they’re not dangerous. Most people are able to work around it and manage it.”

Below, we’ll explore some ways to help you cope with common antipsychotic side effects.

Take Your Medication as Prescribed

Some side effects can get worse or can be caused by not taking your medication the way you should. For example, if you’re taking a medication that makes you drowsy, your healthcare provider may recommend that you take it at night. If you forget and take your medication in the morning, you’re likely to feel more drowsy.

If you stop taking your medication, you can also experience withdrawal symptoms. Some of these symptoms can feel like medication side effects, including anxiety, mood changes, and movement disorders.

If you’re unsure of how and when to take your medication, talk to your healthcare provider. You can learn more tips to help you follow your schizophrenia treatment plan.

Check In With Your Healthcare Provider

Regular check-ins with your healthcare provider can help catch serious side effects early. For example, regular monitoring can help you find movement disorders. Medication-associated movement problems are also known as extrapyramidal side effects. This type of side effect is caused by medications that affect dopamine. While extrapyramidal side effects are more common with first-generation antipsychotics, they can also develop with second-generation antipsychotics.

Your healthcare provider will monitor you closely for a few weeks when starting a new antipsychotic medication to look for extrapyramidal side effects. They may ask you about symptoms like:

• Restlessness
• Tremors (shaking)
• Slow movement
• Muscle stiffness
• Muscle spasms
• Smacking lips
• Grimacing
• Tongue movements
• Involuntary movements

Catching these side effects early can help your healthcare team develop the best treatment plan for you. They may lower the dose of your medication or switch to another antipsychotic medication if necessary. If a new dose or drug doesn’t work, adding medications like propranolol or benztropine may be an option to help you manage these side effects.

Add Healthy Lifestyle Changes

To help prevent serious health problems and boost your overall well-being, you can add healthy lifestyle habits to your treatment plan. These might include:

• Eating a healthy diet with plenty of fruits, vegetables, and whole grains
• Limiting foods with lots of sugar and unhealthy fats
• Managing your portion sizes
• Getting regular exercise
• Avoiding alcohol
• Quitting smoking

Weight gain is a common side effect of many antipsychotic medications, especially second-generation antipsychotics.

Part of the reason for weight gain is that these medications can increase your appetite. Additionally, if your medication makes you feel drowsy, you may not get as much physical activity.

If you gain weight, your risk of other health conditions like heart problems and diabetes may increase. Some antipsychotics are more likely to cause weight gain than others. If you are concerned about weight changes, talk to your healthcare provider to see if switching your antipsychotic medication may help avoid weight gain.

Find Your Team

On MySchizophreniaTeam, the site for those living with schizophrenia and their loved ones, people come together to ask questions, give advice, and share their stories with others who understand life with schizophrenia.

Have you experienced schizophrenia medication side effects? What tips do you have for coping with side effects? Share your experience in the comments below.