Mental health

Medicines for Schizophrenia & psychosis

A serious mental illness where a person loses some contact with reality — treated with antipsychotic medicines alongside psychological and social support, with early treatment and monitoring central to recovery.

Education and reference only. This explains which medicines are used and why, in plain language — it deliberately contains no doses and is not a substitute for advice from your doctor or pharmacist. Always discuss your own treatment with a qualified clinician, and check the BNF and the product labelling for prescribing detail.

Written by Meds Global Health Clinical Team · Clinically reviewed by Dr Muhammad Suffyan, MB BS, Founder & Clinical Director · Last reviewed · How we review

Quick answer

What is Schizophrenia & psychosis?

Schizophrenia is a serious long-term mental illness in which a person experiences psychosis — losing some contact with reality. This can include hallucinations (such as hearing voices that others cannot hear), delusions (strongly held beliefs that are not based in reality), and muddled or disordered thinking.

  • How it is treated: Treatment combines medicine with psychological and social support — it is never medicine alone.
  • Self-care: Stopping smoking, staying physically active, eating well and avoiding street drugs (which can trigger or worsen psychosis) all support recovery, as does keeping a stable routine and strong social and family support.
  • When to seek help: A first episode of psychosis, or a relapse, needs prompt assessment by a mental-health team — contact your GP or crisis team, or call 111.

What it is

Schizophrenia is a serious long-term mental illness in which a person experiences psychosis — losing some contact with reality. This can include hallucinations (such as hearing voices that others cannot hear), delusions (strongly held beliefs that are not based in reality), and muddled or disordered thinking. There are also so-called negative symptoms — reduced motivation, withdrawal, flattened emotion — and difficulties with concentration and memory, which can be just as disabling. Psychosis is not the same as a "split personality", and it is not a sign of a violent nature. It often first appears in late adolescence or early adulthood, and a first episode is a key moment: getting help and treatment early gives the best chance of recovery.

How it is treated

Treatment combines medicine with psychological and social support — it is never medicine alone. Antipsychotic medicines are the mainstay: they reduce and help prevent the psychotic symptoms of hallucinations and delusions. Alongside them, talking therapies such as cognitive behavioural therapy for psychosis, family support, and help with housing, work and daily living all matter. Because antipsychotics have side effects, treatment is monitored carefully: metabolic effects (weight, blood glucose and lipids), movement effects, and sedation are all checked over time. When schizophrenia has not responded to other antipsychotics, clozapine is the most effective option, but it requires regular, mandatory blood tests. Treatment is usually continued long-term, because the risk of relapse is high if it is stopped, and any decision to reduce or stop is made gradually and with the team.

For this condition, these medicines

Medicine classes used for Schizophrenia & psychosis

Each links to a full, dose-free guide — what it is, how it works, who can and cannot use it, side effects, interactions and FAQs.

Antipsychotics Mental health The mainstay of treatment; they reduce and help prevent psychotic symptoms such as hallucinations and delusions. Clozapine Mental health Used for schizophrenia that has not responded to other antipsychotics — the most effective option, but needs regular blood monitoring.

Symptom checker

Symptoms that can point to Schizophrenia & psychosis

Schizophrenia & psychosis can be one cause of these symptoms. Each guide explains the other possible causes and the red-flag warning signs that mean you should get urgent help:

Seeing or hearing things that are not thereSeeing, hearing, feeling or smelling things that are not really there, which can have many…

By active ingredient

Specific medicines used for Schizophrenia & psychosis

Dose-free guides to individual active ingredients used in schizophrenia & psychosis — what each is, how it works, how to take it, and its advantages and disadvantages:

QuetiapineAn atypical antipsychotic used in schizophrenia and bipolar disorder; can cause sedation, …OlanzapineAn effective atypical antipsychotic for schizophrenia and bipolar disorder, well known for…AripiprazoleAn atypical antipsychotic for schizophrenia and bipolar disorder that tends to be more wei…RisperidoneA widely used atypical antipsychotic for schizophrenia and bipolar disorder, available as …HaloperidolA long-established first-generation antipsychotic used for schizophrenia, agitation and ot…LurasidoneA second-generation antipsychotic used for schizophrenia, often chosen for its relatively …PaliperidoneA second-generation antipsychotic for schizophrenia, available as daily tablets or as a lo…SulpirideAn antipsychotic used to treat schizophrenia; it can raise prolactin and cause movement ef…AmisulprideA second-generation antipsychotic used for schizophrenia that can calm symptoms at higher …ChlorpromazineAn older 'first-generation' antipsychotic used to treat schizophrenia and other conditions…FlupentixolAn antipsychotic for schizophrenia that can be taken as tablets or given as a long-acting …TrifluoperazineA first-generation antipsychotic used in schizophrenia and other psychosis, and at lower a…PericyazineA first-generation (older) antipsychotic used for schizophrenia and severe agitation.…ZuclopenthixolAn older antipsychotic for schizophrenia, available as tablets and as a long-acting depot …CariprazineA second-generation antipsychotic for schizophrenia with a long-lasting effect in the body…PericiazineAn older phenothiazine antipsychotic, also used for severe anxiety or agitation, that is m…PimozideAn antipsychotic tablet used for schizophrenia and a specific delusional condition, which …PipotiazineA long-acting antipsychotic given by injection to maintain treatment for schizophrenia.…FluphenazineAn older antipsychotic used for schizophrenia, often as a long-acting depot injection that…PerphenazineA first-generation antipsychotic used for conditions such as schizophrenia, and also to tr…ZiprasidoneA second-generation antipsychotic used for schizophrenia and bipolar disorder, taken with …BrexpiprazoleA newer antipsychotic used for schizophrenia and as an add-on in depression that has not r…IloperidoneA second-generation antipsychotic used to treat schizophrenia, with the dose built up slow…ThiothixeneA first-generation antipsychotic used to treat schizophrenia, more commonly seen as a Unit…Aripiprazole lauroxilA long-acting depot injection of the antipsychotic aripiprazole, given every few weeks to …LumateperoneA newer once-daily antipsychotic used for schizophrenia and for bipolar depression.…MolindoneAn older first-generation antipsychotic used to treat schizophrenia, mainly available in t…ClozapineThe most effective medicine for schizophrenia that has not responded to other treatments —…

Beyond medication

Lifestyle and self-care

Stopping smoking, staying physically active, eating well and avoiding street drugs (which can trigger or worsen psychosis) all support recovery, as does keeping a stable routine and strong social and family support.

When to get help

When to see a doctor

A first episode of psychosis, or a relapse, needs prompt assessment by a mental-health team — contact your GP or crisis team, or call 111. If a person is at immediate risk of harming themselves or others, this is an emergency — call 999. If you or someone you care for is having thoughts of suicide, you can also call the Samaritans on 116 123 at any time.

999Emergency — call 999 or go to A&E
111Urgent advice — call NHS 111 or use 111 online
GPNon-urgent — see your GP or pharmacist

Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.

Answers

Schizophrenia & psychosis: frequently asked questions

What medicines are used for schizophrenia?

Antipsychotic medicines are the mainstay — they reduce and help prevent psychotic symptoms such as hearing voices and delusions. When the illness has not responded to other antipsychotics, clozapine is the most effective option, but it requires regular blood tests for safety. Medicines work best alongside talking therapy and social support.

Why does clozapine need regular blood tests?

Clozapine is highly effective for schizophrenia that has not responded to other treatments, but in a small number of people it can cause a dangerous fall in the white blood cells that fight infection (agranulocytosis). Regular, mandatory blood monitoring catches this early, which is why it is built into clozapine treatment and cannot be skipped.

What side effects should be watched for with antipsychotics?

Common ones include metabolic effects (weight gain and changes in blood glucose and cholesterol), movement effects such as stiffness or restlessness, and drowsiness. These are monitored with regular checks so they can be managed early. Tell your team about any new or troubling effects rather than stopping the medicine yourself.

Can I stop my antipsychotic if I feel well?

Feeling well is usually a sign the medicine is working, not that it is no longer needed. Stopping — especially suddenly — carries a high risk of relapse. Any change should be planned gradually with your mental-health team, who will weigh up your individual situation.

Keep reading

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Sources

Where this is drawn from

  • NICE CG178: Psychosis and schizophrenia in adults: prevention and management.
  • NICE CKS: Schizophrenia.

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