Switching Schizophrenia Medication: 7 Factors To Consider

Finding the right schizophrenia medication isn’t always easy. You might need to try more than one treatment to find one that helps you feel more like yourself. This process can be frustrating, especially if your current medication isn’t helping or causes difficult side effects.

Switching medications can feel overwhelming, but you’re not alone. Knowing what to expect can help you feel more prepared and confident to talk about your options with your healthcare provider. In this article, we’ll cover some key factors to keep in mind before making a switch.

1. People Switch Schizophrenia Medications for Different Reasons

Antipsychotic medications are the main type of medication prescribed to treat schizophrenia. Several types of antipsychotics are available, and each can affect people differently. Because of this, people may want to switch their antipsychotic medication for many reasons, including:

• Lack of improvement in schizophrenia symptoms
• Unbearable side effects
• Difficulty sticking to the treatment plan
• High medication costs
• Preference for another medication
• A new health problem that doesn’t mix well with the medication

Whatever the reason, it’s important to talk with your healthcare provider about your options. Never stop or change your schizophrenia medication without first checking with your healthcare team.

2. It Takes Time To See the Full Effect of a New Medication

Before you switch antipsychotic medications, it’s important to first see if your current one is working. Doctors and researchers recommend taking an effective dose for at least six weeks to notice the full effect.

Switching medications can worsen symptoms or cause new side effects, so it’s important to make sure your current medication really isn’t the right fit. Your healthcare provider may also make sure you’re taking your medication as prescribed. Frequently missing doses can make your antipsychotic medication less effective. Finding ways to stick to your treatment plan may help your current medication work better for you.

Your healthcare provider may also check your current medication dose before switching. They may suggest increasing to a more effective dose before trying something else.

Before you switch antipsychotics, your healthcare provider may consider other factors that could impact your treatment, including:

• Other mental health conditions
• Drug interactions
• Food interactions
• Genetic differences in how you respond to your current medication

3. No Single Schizophrenia Medication Works Best for Everyone

There isn’t one antipsychotic medication that works for all cases of schizophrenia. To help find the right one for you, your healthcare provider will consider several factors, such as:

• Your response to other antipsychotic medications you’ve taken
• Common side effects of the drug
• The dosing schedule (how often it’s taken)
• Your comorbidities (other medical conditions)
• Your ability to follow your treatment plan
• Your preferences

If you have trouble remembering to take your daily medication, you might consider a long-acting injectable antipsychotic medication. These medicines are injected into your muscle or under your skin at regular intervals, such as every two to four weeks or every six months. A long-acting injectable antipsychotic may be a good option if you want to take fewer pills or if you have trouble sticking to your treatment plan.

If you don’t get better after trying at least two antipsychotic medications, you may have treatment-resistant schizophrenia. In that case, the antipsychotic medication clozapine (Clozaril) is recommended. Between 60 percent and 70 percent of people with treatment-resistant schizophrenia see their symptoms improve with clozapine.

4. Side Effects May Not Improve Right Away

Side effects are often the main reason people want to switch schizophrenia medications. However, it’s important to realize that side effects may not improve right away, and a new medication can have its own side effects. For example, drowsiness and dizziness often improve a few weeks after starting a medication, but other side effects may remain or take longer to improve.

Your healthcare provider can suggest a new medication with a lower risk of the side effects you’re dealing with. Different antipsychotics have different sets of side effects. Having an open and honest conversation with your healthcare team about how side effects affect your quality of life can help you and your provider choose the best medication for you.

Although antipsychotic drugs affect everyone differently, some side effects are more common with certain medications. For example, if you have abnormal movements with your current antipsychotic, your healthcare provider may recommend switching to one of the following treatments:

• Aripiprazole (Abilify)
• Olanzapine (Zyprexa)
• Quetiapine (Seroquel)

If you’re switching because of unwanted weight gain, lurasidone (Latuda) or ziprasidone (Geodon) might be recommended.

5. Stopping Antipsychotic Medications Can Cause Withdrawal Symptoms

Withdrawal symptoms are the unwanted effects of stopping a medication. Not everyone gets withdrawal symptoms when they stop an antipsychotic, but they can be uncomfortable when they do happen. Possible withdrawal symptoms include:

• Abnormal skin sensations
• Mood changes
• Flu-like symptoms
• Diarrhea
• Dizziness
• Trouble sleeping
• Loss of appetite
• Involuntary movements

You’re more likely to have withdrawal symptoms if you stop your antipsychotic medication suddenly. Slowly lowering your dose over time can lower your risk. Your healthcare provider can guide you on how to safely reduce and stop your current antipsychotic medication while switching to a new one.

6. You Might Take Two Schizophrenia Medications for a While

Your healthcare provider may recommend taking two schizophrenia medications at the same time for a short period while switching. Your switching strategy depends on your reason for the change.

If your current medication isn’t working, you might continue taking it at the same dose until the new medication reaches an effective dose. Then you can slowly lower the first drug’s dose.

If you’re switching because of side effects, your doctor may suggest slowly decreasing the first medication over one to two weeks while also slowly increasing the new one. This method is called cross titration.

The simplest strategy is a direct switch. The first antipsychotic drug is stopped on one day and a new one is started the next. This approach increases the risk of withdrawal symptoms, so it’s best done during a hospital stay.

Taking more than one schizophrenia medication at a time can be complicated. It’s important to make sure you have the support you need during this time.

7. Plan the Timing of Your Switch Carefully

Switching antipsychotic medications can cause your symptoms to return or worsen. You might also develop new symptoms from withdrawal. Because of this, most medical professionals don’t recommend switching antipsychotic medications if you’ve recently recovered from an episode of psychosis (when you’re disconnected from reality).

A 2020 study found that people with schizophrenia, bipolar disorder, or depression who switched antipsychotics were more likely to have their symptoms return sooner than those who stayed on the same medication. These results don’t mean that switching directly causes symptoms to return. It could mean that people with more severe symptoms are more likely to switch schizophrenia medications.

It’s important to make sure you have the support you need while switching medications. Caregivers and family members can play an important role in getting you through the process. Try to plan your switch for a time when your support system is available to help.

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 switched schizophrenia medications? What tips do you have for someone considering a new schizophrenia medication? Share your experience in the comments below.