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Schizophrenia Treatment Options

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Aripiprazole

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Partial agonist at D2 receptors, effective for positive and some negative symptoms. Side effects include headache, anxiety, insomnia, and risk of extrapyramidal symptoms (EPS).

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Clozapine

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Effective for treatment-resistant schizophrenia for both positive and negative symptoms. Side effects include agranulocytosis, weight gain, sedation, and anticholinergic effects.

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Olanzapine

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Effective for positive and negative symptoms. Side effects include significant weight gain, metabolic syndrome, sedation, and anticholinergic effects.

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Risperidone

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Effective for positive symptoms and some negative symptoms. Side effects include EPS, hyperprolactinemia, weight gain, and metabolic changes.

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Quetiapine

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Effective for positive symptoms; efficacy for negative symptoms is less established. Side effects include sedation, orthostatic hypotension, and weight gain.

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Haloperidol

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Highly effective for positive symptoms but limited efficacy for negative symptoms. Side effects include high risk of EPS, tardive dyskinesia, and anticholinergic effects.

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Lurasidone

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Effective for positive and negative symptoms; has a favorable side effect profile with less weight gain. Side effects include akathisia, sedation, and nausea.

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Ziprasidone

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Effective for positive and negative symptoms; lower risk of weight gain. Side effects include QT prolongation, sedation, and EPS at higher doses.

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Amisulpride

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Selective for D2/D3 receptors, effective for positive and negative symptoms. Side effects include increased prolactin levels, EPS, and insomnia.

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Paliperidone

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Effective for both positive and negative symptoms. Side effects include EPS, tachycardia, weight gain, and increased prolactin levels.

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Asenapine

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Efficacy for positive and mixed results for negative symptoms. Side effects include oral hypoesthesia, weight gain, and EPS.

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Iloperidone

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Efficacy for positive symptoms, and lesser data on negative symptoms. Side effects include weight gain, dizziness, fatigue, and nasal congestion.

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Cariprazine

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Effective for positive and negative symptoms, acts as a D2 and D3 partial agonist. Side effects include EPS, akathisia, and gastrointestinal symptoms.

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Brexpiprazole

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Effective for positive symptoms and may have benefits for negative symptoms. Side effects include weight gain, nasopharyngitis, and EPS.

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Perphenazine

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Effective for positive symptoms, with questionable effects on negative symptoms. Side effects include EPS, especially at higher doses, weight gain, and anticholinergic effects.

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Chlorpromazine

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Effective for positive symptoms, less so for negative symptoms. Side effects include sedation, hypotension, weight gain, and considerable anticholinergic effects.

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Thioridazine

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Effective for positive symptoms, and less data on negative symptoms. Side effects include QT prolongation, sedation, weight gain, and anticholinergic effects.

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Zotepine

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Effective for positive and negative symptoms. Side effects include drowsiness, increased appetite, EPS, and anticholinergic effects.

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Fluphenazine

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Effective for positive symptoms, unclear benefits for negative symptoms. Side effects include high risk of EPS, and also weight gain, and hypotension.

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Sertindole

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Effective for positive and negative symptoms. Side effects include QT prolongation, less weight gain than other atypicals, and lower risk of EPS.

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