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Antipsychotic medications are the cornerstone of treatment for schizophrenia. It is clear that antipsychotic medications eliminate or lessen the symptoms of schizophrenia in most patients. Without medications, symptoms will almost always recur. With each recurrence of symptoms, response to medications may take longer and may not be as good. Some people may continue to experience symptoms even on medications, although to a lesser degree than if they were on no medications. For medication treatment to be most effective, patients should take medications when symptoms first occur, and stay on medications even if symptoms go away entirely, to help prevent future relapses. Research now suggests that ongoing hallucinations and delusions are symptoms of a toxic brain process, which may be further damaging the brain. Control of the symptoms may mean that this brain damaging process is also halted. In addition, several studies have shown that the earlier a person with schizophrenia gets treatment, the more mild the illness.

Antipsychotic medications may have troublesome side effects. This is especially true for the older medications (chlorpromazine, thioridazine, mesoridazine, fluphenazine, trifluoperazine, perphenazine, thiothixene, molindone, loxapine, haloperidol), where side effects such as a “zombie” feeling, muscle stiffness, sedation, dry mouth, constipation, blurred vision, and many others are very common. Newer medications (risperidone, olanzapine, quetiapine) offer the hope of being an effective treatment for hallucinations and delusions, with far fewer side effects. We are finding that patients are more willing to take the newer medications, and that patients taking them often report no side effects at all. However, the newer medications do not work for everybody and still cause side effects in some people-weight gain is often a problem. Like the treatment of diabetes with insulin, the antipsychotic medications control the symptoms but do not cure the disease. Thus, there continues to be active research to find newer and better medication treatments.