Explore and compare different medications below so you and your healthcare team can decide which medication is best for you.
Amisulpride
Amisulpride carries a higher risk of hormonal side effects, especially in younger people, so it can be harder to use this medicine in adolescents and young adults. Amisulpride is sometimes used in combination with other antipsychotics such as clozapine.
Amisulpride
Drowsiness, lethargy
Increased appetite, weight gain
Stiff or shaky muscles
Restlessness
Dry mouth, constipation, blurred vision
Dizziness
Hormonal side effects
Aripiprazole
Aripiprazole carries a very low risk of weight gain and hormonal side effects. Sometimes it is even used to manage these side effects caused by other antipsychotics. It can help people feel more alert, which may be a good thing, but can also make falling asleep difficult. Restlessness can also be a problem, especially in the first few weeks after starting aripiprazole but it improves with time for most people.
Aripiprazole
Drowsiness, lethargy
Increased appetite, weight gain
Stiff or shaky muscles
Restlessness
Dry mouth, constipation, blurred vision
Dizziness
Hormonal side effects
Chlorpromazine
Chlorpromazine is the oldest antipsychotic. It was discovered in 1950 by accident during a search for new antihistamines (medicines for allergy). It is usually quite sedating, which can be helpful for sleep and calming effects - but not so good if this affects daily activities. It may cause dizziness and hormonal side effects.
Chlorpromazine
Drowsiness, lethargy
Increased appetite, weight gain
Stiff or shaky muscles
Restlessness
Dry mouth, constipation, blurred vision
Dizziness
Hormonal side effects
Clozapine
Clozapine is very effective in treating psychosis for people who don't respond well to other antipsychotics. It is also the only antipsychotic proven to reduce the risk of self-harm. It tends to have more side effects than others including weight gain, sedation, constipation, too much saliva (spit) production and low white blood cells. Careful monitoring is needed including regular blood tests for the whole time a person takes clozapine.
Clozapine
Drowsiness, lethargy
Increased appetite, weight gain
Stiff or shaky muscles
Restlessness
Dry mouth, constipation, blurred vision
Dizziness
Hormonal side effects
Flupenthixol
Flupenthixol is an older antipsychotic, only available as a long acting injection (also known as a depot) in New Zealand. It was also used as a treatment for depression back in the 70’s and 80’s. Movement side effects and hormonal side effects are common with this medicine.
Flupenthixol
Drowsiness, lethargy
Increased appetite, weight gain
Stiff or shaky muscles
Restlessness
Dry mouth, constipation, blurred vision
Dizziness
Hormonal side effects
Haloperidol
Haloperidol is an older antipsychotic that is sometimes used as a short term treatment when people are distressed or agitated in hospital. It can also be used over a longer period of time as tablets, liquid or a long acting injection. Common side effects include muscle stiffness and restlessness. It doesn’t help much with motivation, focus and attention, and might actually make these worse in some people if the dose is too high.
Haloperidol
Drowsiness, lethargy
Increased appetite, weight gain
Stiff or shaky muscles
Restlessness
Dry mouth, constipation, blurred vision
Dizziness
Hormonal side effects
Olanzapine
Olanzapine is often used for its calming effects when a person is distressed. It is available in tablets and a long acting injection. It seems to be slightly more effective than other antipsychotics (except clozapine). A lot of people find olanzapine makes them really hungry, which can lead to weight gain.
Olanzapine
Drowsiness, lethargy
Increased appetite, weight gain
Stiff or shaky muscles
Restlessness
Dry mouth, constipation, blurred vision
Dizziness
Hormonal side effects
Paliperidone
Paliperidone is only available as a long acting monthly injection. It tends to cause less sleepiness than some of the other antipsychotics. However, movement and hormonal side effects are more common.
Paliperidone
Drowsiness, lethargy
Increased appetite, weight gain
Stiff or shaky muscles
Restlessness
Dry mouth, constipation, blurred vision
Dizziness
Hormonal side effects
Pericyazine
Pericyazine is an older medicine not used very much for psychosis anymore - other medicines are usually preferred. Like all older antipsychotics, it can cause movement and hormonal side effects. Weight gain and drowsiness are also quite common.
Pericyazine
Drowsiness, lethargy
Increased appetite, weight gain
Stiff or shaky muscles
Restlessness
Dry mouth, constipation, blurred vision
Dizziness
Hormonal side effects
Quetiapine
Quetiapine has some antidepressant effects, so might be good for people experiencing psychosis who also have a low mood or depression. It has a very low risk of movement and hormonal side effects, but often causes increased appetite and weight gain.
Quetiapine
Drowsiness, lethargy
Increased appetite, weight gain
Stiff or shaky muscles
Restlessness
Dry mouth, constipation, blurred vision
Dizziness
Hormonal side effects
Risperidone
Risperidone is available as tablets, liquid and a fortnightly long acting injection. It tends to cause less drowsiness than some other antipsychotics but movement and hormonal side effects are more common.
Risperidone
Drowsiness, lethargy
Increased appetite, weight gain
Stiff or shaky muscles
Restlessness
Dry mouth, constipation, blurred vision
Dizziness
Hormonal side effects
Ziprasidone
Ziprasidone causes less weight gain, sedation and movement and hormonal side effects than some other antipsychotics. It may even increase alertness in some people, especially at lower doses. It is more likely to cause irregular heartbeat than many other antipsychotics so a doctor or nurse may check this at the start of treatment.
Ziprasidone
Drowsiness, lethargy
Increased appetite, weight gain
Stiff or shaky muscles
Restlessness
Dry mouth, constipation, blurred vision
Dizziness
Hormonal side effects
Zuclopenthixol
Zuclopenthixol is an older antipsychotic, which is available as tablets and long acting injection. It tends to be sedating and calming and can help reduce aggression and agitation. As with the other older antipsychotics, movement and hormonal side effects are quite common.
Zuclopenthixol
Drowsiness, lethargy
Increased appetite, weight gain
Stiff or shaky muscles
Restlessness
Dry mouth, constipation, blurred vision
Dizziness
Hormonal side effects
Medication information was compiled from the following sources:
Galletly C, Castle D, Dark F, Humberstone V, Jablensky A, Killackey E, et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders. Australian & New Zealand Journal of Psychiatry. 2016;50(5):410-72.
Haddad PM, Sharma SG. Adverse effects of atypical antipsychotics : differential risk and clinical implications. CNS drugs. 2007;21(11):911-36.
Jibson MD. Second-generation antipsychotic medications: Pharmacology, administration, and side effects. 2017 [last update May 15, 2017] In: UpToDate [Internet]. [cited 2 November 2017]. Available from: https://www.uptodate.com/contents/second-generation-antipsychotic-medications-pharmacology-administration-and-side-effects
Leucht S, Cipriani A, Spineli L, Mavridis D, Orey D, Richter F, et al. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis.
Lancet (London, England). 2013;382(9896):951-62.
Leucht S, Tardy M, Komossa K, Heres S, Kissling W, Salanti G, et al. Antipsychotic drugs versus placebo for relapse prevention in schizophrenia: a systematic review and meta-analysis. The Lancet. 2012;379(9831):2063-71.
Marder S, Stroup T. Pharmacotherapy for schizophrenia: Side effect management. 2017 [last update Dec 01, 2016] In: UpToDate [Internet]. [cited 2 November 2017]. Available from: https://www.uptodate.com/contents/pharmacotherapy-for-schizophrenia-side-effect-management
New Zealand Formulary (NZF). NZF v[64] [Internet]. 2017. Available from: www.nzf.org.nz [accessed 02 November 2017].
Robinson DG, Gallego JA, John M, Petrides G, Hassoun Y, Zhang JP, et al. A Randomized Comparison of Aripiprazole and Risperidone for the Acute Treatment of First-Episode Schizophrenia and Related Disorders: 3-Month Outcomes. Schizophrenia bulletin. 2015;41(6):1227-36.
Stahl SM. Stahl's Essential Psychopharmacology : Neuroscientific Basis and Practical Application. 4th ed. Cambridge: Cambridge University Press 2013.
Stahl SM. Stahl's Essential Psychopharmacology: The Prescriber's Guide. 6th ed. Cambridge: Cambridge University Press 2017.
Taylor D, Paton C, Kapur S. The Maudsley prescribing guidelines in psychiatry. Twelfth edition. West Sussex, England : Wiley Blackwell. 2015.
Zhu Y, Li C, Huhn M, Rothe P, Krause M, Bighelli I, et al. How well do patients with a first episode of schizophrenia respond to antipsychotics: A systematic review and meta-analysis. European Neuropsychopharmacology. 2017;27(9):835-44.
Like any other medication, antipsychotics can cause side effects. While side effects may seem scary, they can be managed. Overall, the benefits of antipsychotics outweigh the downsides for most people.
Common side effects
Rare side effects
Medication information on this page was compiled from the following sources:
What are my rights if I am assessed as having a mental disorder?
The Mental Health Act sets out eleven basic patient rights.
A patient has the right to:
- Information (e.g. about their legal status, their treatment and likely side effects)
- Respect for cultural identity (e.g. their cultural and ethnic identity, religious or ethical beliefs)
- An interpreter (even if a person can speak and understand English but prefers to communicate in another language)
- Treatment which is appropriate and of a professional standard
- Be informed about treatment (e.g. what it is for and what the side effects might be)
- Refuse video recording
- Independent psychiatric advice (e.g. if they are concerned about the treatment they are receiving)
- Legal advice (if a person can’t afford a lawyer they may be eligible for legal aid). You can contact your local Community Law Centre. Auckland also has the specialist Auckland Disability Law service which includes mental health. For those under 25 years, Youthlaw has an advice line on 0800 844 529 or email info@youthlaw.co.nz. The New Zealand Law Society has a Find A Family Lawyer Directory and a general Find a Lawyer Directory.
- Company (a person can’t be put into isolation unless it’s necessary for treatment or safety)
- Have visitors and make telephone calls (but a person may lose this right if their clinician believes this would not be in their interest)
- Send and receive mail (hospital staff can’t open patients’ mail - a person may lose this right if their clinician thinks it would not be in their interests, but there are some types of mail which can never be opened or withheld by staff, e.g. from your lawyer)
A person must be given a statement of their rights when they become a patient. More info on Mental Health Act can be found here.
If you have concerns about your rights not being upheld, you can contact a District Inspector, who are lawyers appointed by the Ministry of Health to protect the rights of people receiving treatment under the Mental Health Act. They are independent of the Ministry of Health and Mental Health Services.
What are my rights if I am assessed as having a mental disorder?
The Mental Health Act sets out eleven basic patient rights.
A patient has the right to:
- Information (e.g. about their legal status, their treatment and likely side effects)
- Respect for cultural identity (e.g. their cultural and ethnic identity, religious or ethical beliefs)
- An interpreter (even if a person can speak and understand English but prefers to communicate in another language)
- Treatment which is appropriate and of a professional standard
- Be informed about treatment (e.g. what it is for and what the side effects might be)
- Refuse video recording
- Independent psychiatric advice (e.g. if they are concerned about the treatment they are receiving)
- Legal advice (if a person can’t afford a lawyer they may be eligible for legal aid). You can contact your local Community Law Centre. Auckland also has the specialist Auckland Disability Law service which includes mental health. For those under 25 years, Youthlaw has an advice line on 0800 844 529 or email info@youthlaw.co.nz. The New Zealand Law Society has a Find A Family Lawyer Directory and a general Find a Lawyer Directory.
- Company (a person can’t be put into isolation unless it’s necessary for treatment or safety)
- Have visitors and make telephone calls (but a person may lose this right if their clinician believes this would not be in their interest)
- Send and receive mail (hospital staff can’t open patients’ mail - a person may lose this right if their clinician thinks it would not be in their interests, but there are some types of mail which can never be opened or withheld by staff, e.g. from your lawyer)
A person must be given a statement of their rights when they become a patient. More info on Mental Health Act can be found here.
If you have concerns about your rights not being upheld, you can contact a District Inspector, who are lawyers appointed by the Ministry of Health to protect the rights of people receiving treatment under the Mental Health Act. They are independent of the Ministry of Health and Mental Health Services.
