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Schizophrenia Treatment Options
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Aripiprazole
Partial agonist at D2 receptors, effective for positive and some negative symptoms. Side effects include headache, anxiety, insomnia, and risk of extrapyramidal symptoms (EPS).
Clozapine
Effective for treatment-resistant schizophrenia for both positive and negative symptoms. Side effects include agranulocytosis, weight gain, sedation, and anticholinergic effects.
Olanzapine
Effective for positive and negative symptoms. Side effects include significant weight gain, metabolic syndrome, sedation, and anticholinergic effects.
Risperidone
Effective for positive symptoms and some negative symptoms. Side effects include EPS, hyperprolactinemia, weight gain, and metabolic changes.
Quetiapine
Effective for positive symptoms; efficacy for negative symptoms is less established. Side effects include sedation, orthostatic hypotension, and weight gain.
Haloperidol
Highly effective for positive symptoms but limited efficacy for negative symptoms. Side effects include high risk of EPS, tardive dyskinesia, and anticholinergic effects.
Lurasidone
Effective for positive and negative symptoms; has a favorable side effect profile with less weight gain. Side effects include akathisia, sedation, and nausea.
Ziprasidone
Effective for positive and negative symptoms; lower risk of weight gain. Side effects include QT prolongation, sedation, and EPS at higher doses.
Amisulpride
Selective for D2/D3 receptors, effective for positive and negative symptoms. Side effects include increased prolactin levels, EPS, and insomnia.
Paliperidone
Effective for both positive and negative symptoms. Side effects include EPS, tachycardia, weight gain, and increased prolactin levels.
Asenapine
Efficacy for positive and mixed results for negative symptoms. Side effects include oral hypoesthesia, weight gain, and EPS.
Iloperidone
Efficacy for positive symptoms, and lesser data on negative symptoms. Side effects include weight gain, dizziness, fatigue, and nasal congestion.
Cariprazine
Effective for positive and negative symptoms, acts as a D2 and D3 partial agonist. Side effects include EPS, akathisia, and gastrointestinal symptoms.
Brexpiprazole
Effective for positive symptoms and may have benefits for negative symptoms. Side effects include weight gain, nasopharyngitis, and EPS.
Perphenazine
Effective for positive symptoms, with questionable effects on negative symptoms. Side effects include EPS, especially at higher doses, weight gain, and anticholinergic effects.
Chlorpromazine
Effective for positive symptoms, less so for negative symptoms. Side effects include sedation, hypotension, weight gain, and considerable anticholinergic effects.
Thioridazine
Effective for positive symptoms, and less data on negative symptoms. Side effects include QT prolongation, sedation, weight gain, and anticholinergic effects.
Zotepine
Effective for positive and negative symptoms. Side effects include drowsiness, increased appetite, EPS, and anticholinergic effects.
Fluphenazine
Effective for positive symptoms, unclear benefits for negative symptoms. Side effects include high risk of EPS, and also weight gain, and hypotension.
Sertindole
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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