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:
Tools & resources for wellbeing
Here are some cool online tools and resources for keeping well:
Auntie Dee
Auntie Dee is a free online New Zealand tool for anyone who needs some help working through a problem or problems, no matter what they are. The team behind Auntie Dee are a non-government organisation called Le Va. They focus on Pasifika wellbeing in an holistic way – taking into account all dimensions of a person, family or community – physical, mental, social, environmental and spiritual.
bphope
bphope is an award-winning, online community. It strives to increase the awareness of bipolar disorder and to provide hope and empowerment to those in the bipolar community — people with bipolar disorder, along with their families, caregivers, and health-care professionals. The website is filled with inspirational features and first-person profiles, the latest news and research and educational information for building a healthy lifestyle including: stress reduction, exercise, sleep, treatment, relationships and employment.
Changing Minds
Changing Minds supports people who access mental health and addiction services in New Zealand through information, education and resources, and by providing a platform for people to have their voices heard. Changing Minds values whakawhanaungatanga (connections), manaakitanga (hospitality), and kohatitanga (togetherness) to create safe spaces for people to share their experiences and stories about their own journey with mental health and wellbeing.
CALM
Computer Assisted Learning for the Mind
Engage Aotearoa
Engage Aotearoa is a recovery promotion project governed by Community Mental Health Resources Trust (CMHRT) that aims to make it easier for other people to find the hopeful understandings, practical strategies, treatments and community connections needed to recover from a mental health problem.
OnTrack
OnTrack Get Real is a free online treatment program primarily for young people who are having odd or strange experiences, and who need help figuring out what's 'real'. The program may also help people cope in the early stages of psychosis, where they may be hearing voices or feel suspicious of other people. The program was written by psychologists and uses methods that have been shown in research to be helpful.
The Lowdown
The Lowdown is a website to help young New Zealanders recognise and understand depression or anxiety. It features videos of real young people telling their stories and provides topics such as healthy behaviours to build resilience and quick steps to help build healthy mental wellbeing.
The Wellness Recovery Action Plan (WRAP)
A prevention and wellness process that anyone can use to get well, stay well and make their life the way they want it to be. It is now used extensively by people in all kinds of circumstances, and by health care and mental health systems all over the world to address all kinds of physical, mental health and life issues.
A booklet written by people who have experienced psychosis describing the points of contact between the knowledge and experience of experts on the one hand, and the experiences of people susceptible to psychosis on the other hand.
Having suicidal thoughts and finding a way back is a book put together by people who have lived through suicidal thoughts and experiences.
Professionally-reviewed mobile apps and tools to help you look after your health and wellbeing
Tools & resources for wellbeing
Here are some cool online tools and resources for keeping well:
Auntie Dee
Auntie Dee is a free online New Zealand tool for anyone who needs some help working through a problem or problems, no matter what they are. The team behind Auntie Dee are a non-government organisation called Le Va. They focus on Pasifika wellbeing in an holistic way – taking into account all dimensions of a person, family or community – physical, mental, social, environmental and spiritual.
bphope
bphope is an award-winning, online community. It strives to increase the awareness of bipolar disorder and to provide hope and empowerment to those in the bipolar community — people with bipolar disorder, along with their families, caregivers, and health-care professionals. The website is filled with inspirational features and first-person profiles, the latest news and research and educational information for building a healthy lifestyle including: stress reduction, exercise, sleep, treatment, relationships and employment.
Changing Minds
Changing Minds supports people who access mental health and addiction services in New Zealand through information, education and resources, and by providing a platform for people to have their voices heard. Changing Minds values whakawhanaungatanga (connections), manaakitanga (hospitality), and kohatitanga (togetherness) to create safe spaces for people to share their experiences and stories about their own journey with mental health and wellbeing.
CALM
Computer Assisted Learning for the Mind
Engage Aotearoa
Engage Aotearoa is a recovery promotion project governed by Community Mental Health Resources Trust (CMHRT) that aims to make it easier for other people to find the hopeful understandings, practical strategies, treatments and community connections needed to recover from a mental health problem.
OnTrack
OnTrack Get Real is a free online treatment program primarily for young people who are having odd or strange experiences, and who need help figuring out what's 'real'. The program may also help people cope in the early stages of psychosis, where they may be hearing voices or feel suspicious of other people. The program was written by psychologists and uses methods that have been shown in research to be helpful.
The Lowdown
The Lowdown is a website to help young New Zealanders recognise and understand depression or anxiety. It features videos of real young people telling their stories and provides topics such as healthy behaviours to build resilience and quick steps to help build healthy mental wellbeing.
The Wellness Recovery Action Plan (WRAP)
A prevention and wellness process that anyone can use to get well, stay well and make their life the way they want it to be. It is now used extensively by people in all kinds of circumstances, and by health care and mental health systems all over the world to address all kinds of physical, mental health and life issues.
A booklet written by people who have experienced psychosis describing the points of contact between the knowledge and experience of experts on the one hand, and the experiences of people susceptible to psychosis on the other hand.
Having suicidal thoughts and finding a way back is a book put together by people who have lived through suicidal thoughts and experiences.
Professionally-reviewed mobile apps and tools to help you look after your health and wellbeing
