What medication is used to calm schizophrenia? An overview of antipsychotics

October 8, 2025 •

4 min read

Over 50% of individuals with schizophrenia experience poor medication adherence, underscoring the complexities involved in treatment. When it comes to managing this condition, understanding what medication is used to calm schizophrenia is the first step toward effective care. Antipsychotic medications are the cornerstone of treatment, targeting the neurochemical imbalances that cause psychosis.

Quick Summary

Antipsychotic medications are the primary pharmacological tool used for schizophrenia to manage symptoms like hallucinations and agitation. These medications, categorized as first-generation or second-generation, alter brain chemicals like dopamine and serotonin to promote a calmer, more stable state. The choice of medication depends on the patient's symptoms, side effect profile, and response to treatment.

Key Points

Antipsychotics are the primary treatment: These medications are the core pharmacological therapy for managing schizophrenia symptoms like hallucinations and delusions.
First-generation (typical) antipsychotics: Older drugs like haloperidol primarily block dopamine receptors and carry a higher risk of movement-related side effects.
Second-generation (atypical) antipsychotics: Newer drugs like risperidone and olanzapine affect both dopamine and serotonin, offering broader symptom control with a lower risk of motor side effects, but a higher risk of metabolic issues.
Long-acting injectables (LAIs) improve adherence: These injectable forms of medication can help patients who struggle with remembering daily doses, reducing the risk of relapse.
Clozapine is for treatment-resistant cases: This specific second-generation drug is reserved for patients who do not respond to other antipsychotics, as it can have more severe side effects.
Medication is part of a holistic approach: For optimal results, medication should be combined with therapies like CBT, social skills training, and a healthy lifestyle.

Understanding Antipsychotic Medications for Schizophrenia

The primary treatment for schizophrenia involves antipsychotic medications, which are highly effective at controlling psychotic symptoms such as delusions, hallucinations, and severe agitation. These drugs function by altering the levels of key neurotransmitters, or brain chemicals, to regulate mood, perception, and thought processes. Most antipsychotics work by blocking dopamine receptors in the brain, helping to reduce the overactivity of dopamine that is thought to contribute to psychotic symptoms. Newer, second-generation antipsychotics also affect serotonin and other receptors, providing a broader range of action.

First-Generation (Typical) Antipsychotics

Developed in the 1950s, first-generation antipsychotics (FGAs) were the initial class of drugs used for schizophrenia. They primarily target and block D2 dopamine receptors in the brain. By reducing dopaminergic neurotransmission, they can significantly reduce positive symptoms like hallucinations and delusions. Examples of these medications include:

Haloperidol (Haldol): A high-potency typical antipsychotic often used for acute agitation.
Chlorpromazine (Thorazine): A low-potency typical antipsychotic.
Fluphenazine (Prolixin): Available in oral and long-acting injectable forms.
Perphenazine (Trilafon): An intermediate-potency drug.

While effective, these older drugs carry a higher risk of extrapyramidal symptoms (EPS), which are movement-related side effects such as tremors, stiffness, and involuntary muscle contractions.

Second-Generation (Atypical) Antipsychotics

Second-generation antipsychotics (SGAs), which became available in the 1990s, have largely replaced FGAs as the first-line treatment for schizophrenia. Their broader mechanism of action involves blocking both dopamine D2 and serotonin receptors, which helps manage both positive symptoms and potentially negative symptoms (e.g., social withdrawal, blunted emotions). They generally have a lower risk of EPS compared to FGAs but are associated with other side effects. Examples include:

Risperidone (Risperdal): Often used for its broad efficacy.
Olanzapine (Zyprexa): Effective but linked to significant weight gain and metabolic changes.
Quetiapine (Seroquel): Known for its sedating properties, which can help with agitation.
Aripiprazole (Abilify): A partial dopamine agonist, often referred to as a third-generation antipsychotic.
Clozapine (Clozaril): An atypical antipsychotic reserved for treatment-resistant schizophrenia due to its effectiveness and risk of serious side effects, such as agranulocytosis.

Comparison of First- and Second-Generation Antipsychotics


Feature	First-Generation (Typical) Antipsychotics	Second-Generation (Atypical) Antipsychotics
Mechanism of Action	Primarily block dopamine D2 receptors.	Block both dopamine D2 and serotonin receptors.
Side Effect Profile	Higher risk of extrapyramidal symptoms (EPS) like muscle stiffness and tremors.	Lower risk of EPS, but higher risk of metabolic issues (weight gain, diabetes, high cholesterol).
Symptom Coverage	Mostly effective for positive symptoms (hallucinations, delusions).	Can be effective for both positive and negative symptoms.
Examples	Haloperidol, Chlorpromazine, Fluphenazine.	Risperidone, Olanzapine, Quetiapine, Aripiprazole.

Medication Adherence and Long-Acting Injectables (LAIs)

A significant challenge in managing schizophrenia is poor medication adherence, with studies showing that over half of patients may not follow their prescribed regimen. Nonadherence can lead to a higher risk of relapse and rehospitalization. To address this, many antipsychotics are available as long-acting injectable (LAI) medications. A single injection can last from several weeks to a few months, ensuring consistent medication levels and reducing the daily burden of remembering pills. LAIs can be particularly beneficial for individuals who struggle with medication routines or have a history of nonadherence.

Beyond Medication: A Holistic Treatment Approach

While antipsychotics are crucial, they are most effective when combined with other therapeutic interventions. A comprehensive treatment plan typically includes:

Psychotherapy: Cognitive Behavioral Therapy (CBT) and other forms of talk therapy can help individuals develop coping strategies and manage symptoms.
Psychoeducation: Educating patients and their families about schizophrenia helps build understanding, reduce stigma, and improve long-term management.
Social Skills Training: This helps individuals improve communication, interpersonal relationships, and daily functioning.
Stress Management: Techniques like mindfulness, yoga, and exercise can help reduce stress, which can sometimes trigger psychotic episodes.
Substance Abstinence: Avoiding drug and alcohol use is vital, as these substances can worsen symptoms.
Healthy Lifestyle: A balanced diet and regular exercise can help manage medication side effects like weight gain.

Conclusion

For those asking "what medication is used to calm schizophrenia?", the answer lies primarily with antipsychotics, a class of drugs that normalize brain chemistry to manage symptoms like hallucinations and agitation. Both first- and second-generation antipsychotics offer effective relief, but the choice between them involves carefully weighing the potential side effects against a patient's individual needs. Second-generation medications are often preferred due to a lower risk of severe movement disorders, though they can have other metabolic side effects. To optimize outcomes, antipsychotic medication is best used as part of a holistic treatment plan that includes therapy, psychoeducation, and lifestyle management. Working closely with a healthcare provider is essential to finding the right medication and ensuring long-term stability and quality of life.

Note: For more information on managing schizophrenia, consult authoritative resources such as the National Alliance on Mental Illness (NAMI).

Frequently Asked Questions

The primary medications used to treat schizophrenia are called antipsychotics. They work by altering brain chemistry to reduce symptoms such as hallucinations, delusions, and disorganized thinking.

First-generation antipsychotics primarily block dopamine receptors and have a higher risk of movement-related side effects. Second-generation antipsychotics block both dopamine and serotonin receptors, have a lower risk of movement issues, but a higher risk of metabolic side effects.

Improvement in severe psychotic symptoms often begins within the first few weeks of starting medication, with the full benefits typically appearing over several months of continued treatment.

Common side effects can include drowsiness, dizziness, dry mouth, weight gain, and muscle stiffness. Second-generation drugs may also increase the risk of diabetes and high cholesterol.

Clozapine is an atypical antipsychotic often used for cases of schizophrenia that have not responded to other treatments. It is highly effective but requires careful monitoring due to potential serious side effects, such as a drop in white blood cell count.

Yes, anti-anxiety drugs, such as benzodiazepines, are sometimes used for the short-term management of severe agitation associated with an acute psychotic episode.

A long-acting injectable (LAI) is an antipsychotic medication that is injected and works over a period of weeks or months. It can improve medication adherence for patients who have difficulty with daily oral medication regimens.

For many individuals, medication is a necessary and highly effective part of a treatment plan. While non-medication strategies like therapy and lifestyle changes are crucial complements, they are generally not sufficient on their own for managing the core symptoms of psychosis.