If you or a loved one has been prescribed an antipsychotic medication for schizophrenia, it’s possible that it might not be a perfect fit. But that’s no reason to give up: If one medication doesn’t work, another might. In fact, many people who have schizophrenia switch medications within a year or two of starting treatment.

Wondering if a new medication can work better? Read on to find out whether you should give your current treatment more time to take effect or ask your doctor about making a change.

Top Reasons to Change Your Schizophrenia Treatment

The decision to switch medications can be the result of a number of factors, such as efficacy, side effects, or even an unwillingness to take the medication, says Joshua Kantrowitz, MD, an associate professor of clinical psychiatry at Columbia University and New York State Psychiatric Institute and the director of the Columbia Schizophrenia Research Center in New York City. At the end of the day, “Often the best medication is the one you agree to take,” Dr. Kantrowitz says.

Often the best medication is the one you agree to take.

— Joshua Kantrowitz, MD

Most important, always talk to your doctor before making any changes to your treatment. Stopping schizophrenia medication altogether has been linked to hospitalizations, relapses, and suicide attempts.

Here are the most common reasons people consider changing schizophrenia medications — and what you can do if any are true for you.

1. Your Symptoms Aren’t Improving — Or Are Getting Worse

About 58 percent of people who have schizophrenia switch medications because the treatment isn’t helping relieve symptoms. But it’s normal to experience some lingering symptoms, including delusions. “Only about 10 percent of people go into full remission,” Kantrowitz says, “and even people in full remission could still have some symptoms.”

If you’re able to go about your daily life with minimal interruptions, there’s a good chance your medication is working well, he says. On the other hand, if your symptoms worsen — especially if they get so bad that you’re increasingly unable to do your job or interact with your loved ones — you may need to adjust your treatment plan in some way, Kantrowitz says.

For example, if you’ve gone to the hospital as a result of your symptoms, your doctor may want to try a different medication to see if it’s more effective, he says.

1. Your Symptoms Aren’t Improving — Or Are Getting Worse

2. You’re Experiencing Side Effects

Some schizophrenia medications come with side effects such as nervousness or weight gain, Kantrowitz says. Weight gain in particular is a big reason people want to switch treatments. And while certain medications “tend to cause more weight gain than others,” he says, “sometimes the trade-off is worth it, if it’s treating the symptoms.”

That said, if a medication leads to weight gain significant enough to cause a secondary condition, such as diabetes, that might be a reason to switch to a different treatment, Kantrowitz says.

3. The Medication Is Too Expensive

More than 90 percent of people who have schizophrenia are on Medicaid or a combination of Medicaid and Medicare. If you don’t have coverage for a particular medication or are having trouble affording treatment, talk to your doctor. They may be able to provide you with free samples for a while or switch you to a less expensive (or generic) form of the medication.

Also consider reaching out to nonprofit programs that can help you cover the costs of your medications, including NeedyMeds, Professional Prescription Advice, and RxAssist.

4. You Don’t Think Medication Is Necessary

It’s common for people who have schizophrenia to believe that hallucinations and delusions are real, Kantrowitz says. Partly because of that, you may start to think you don’t need to take medication. But antipsychotic drugs can help reduce symptoms, including hallucinations and delusions.

In these cases, a caregiver, if you have one, can help keep you on track with your medications. Research shows that the more support you receive as a person with schizophrenia, the more likely you are to keep taking the medication.

4. You Don’t Think Medication Is Necessary

Assess Your Schizophrenia Treatment

What’s Next? Understanding Schizophrenia Treatment Options

4 Treatment Changes Your Doctor May Recommend

If your treatment plan could be better, your doctor may recommend:

Adjusting the dose: Your doctor may have started you out on the lowest dose proven to be effective. But if symptoms persist and make it hard to function day-to-day, they may recommend increasing the dose to see if that does the trick.
Switching to a new medication: If you’re taking close to the maximum dose of a medication or having too many side effects, your doctor may recommend switching to a new medication altogether.
Trying a long-acting injectable medication: If you’re having trouble taking a daily pill, you may be a candidate for a long-acting injectable medication. They stay in your system longer, so they only need to be administered every 2 to 4 weeks.
Talking to a therapist: Along with medication, you can likely benefit from individual talk therapy or family therapy to help you manage schizophrenia. Your doctor can set you up with a referral.

The main treatment for schizophrenia is antipsychotic medication, so there’s a good chance you’ll be prescribed one. Still, there are other therapies available that may also help reduce symptoms.

Some of these, such as individual or family therapy sessions, can be ongoing treatments that aim to boost your coping skills or reframe negative thinking. These can be used alongside other therapies for schizophrenia. Other treatments, such as hospitalization, may only be needed temporarily, if at all.

Antipsychotic medication: These drugs are the most common treatment for schizophrenia. They work by acting on neurotransmitters in the brain to improve function. Most antipsychotic medications target dopamine receptors to help reduce symptoms such as hallucinations and delusions. A newer medication that combines xanomeline and trospium chloride works on different receptors in the brain, called cholinergic receptors, to improve cognitive function.
There are two types of antipsychotics — first generation and second generation (the latter tends to have fewer side effects). Some may be able to be administered every 2 to 4 weeks as a long-acting injection, which may help you stick to the medication schedule.
Individual therapy: During individual talk therapy, a mental health professional can help you improve your thinking, cope with stress, and identify symptoms.
Family therapy: Similar to individual talk therapy, family therapy can help you and your loved ones find support, advice, and coping techniques.
Social skills training: This type of training helps you communicate and socialize more effectively, so you can better interact with people around you.
Electroconvulsive therapy: If you have schizophrenia that’s resistant to treatment, you may be a candidate for electroconvulsive therapy. This procedure involves passing small electric currents through the brain, which may improve the symptoms of certain mental health conditions.
Hospitalization: If symptoms become severe, you may need to be hospitalized for your safety. There, you’ll have a team of medical professionals to care for you.

How to Talk to Your Doctor About Changing Your Schizophrenia Treatment

8 Things to Tell Your Doctor at Your Appointment

How well you’re able to perform your job
How well your relationships are going with friends and family
If you’re going through a particularly stressful period
Whether your symptoms are getting better, getting worse, or staying the same
When your most recent relapse was
Whether you’re taking medication consistently, as directed — and if not, why
When you were last hospitalized (if applicable)
If you’ve been going to individual or family therapy

7 Tips for Switching Schizophrenia Treatments Successfully

The Takeaway

It’s not uncommon for people with schizophrenia to switch to a new treatment within a year or so of starting a medication.
If your current treatment isn’t helping symptoms — for example, you’re experiencing more hallucinations or delusions than usual — mention it to your doctor, who may recommend a new medication.
Adding other treatments to your regimen, such as family therapy or individual therapy, can help you manage symptoms and allow you to function better throughout the day.

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Resources

Khandker R et al. Atypical Treatment Switches in Schizophrenia Patients: Drivers and Associated Outcomes. Neuropsychiatric Disease and Treatment. 2022.
Fee R et al. Reasons for Switching Oral Antipsychotic Medications and Related Patterns of Care and Costs in Patients With Schizophrenia Initiating Monotherapy Treatment: Claims-Linked Chart Study. Journal of Managed Care & Specialty Pharmacy. July 1, 2024.
Haddad PM et al. Nonadherence With Antipsychotic Medication in Schizophrenia: Challenges and Management Strategies. Patient Related Outcome Measures. June 23, 2014.
Schizophrenia Diagnosis & Treatment. Mayo Clinic. October 16, 2024.
FDA Approves Drug With New Mechanism of Action for Treatment of Schizophrenia. U.S. Food and Drug Administration. September 26, 2024.
Electroconvulsive Therapy (ECT). Mayo Clinic. May 30, 2024.
Fee R et al. Patterns of Care and Costs of Switching Oral Antipsychotic Medications in Patients With Schizophrenia Initiating Monotherapy Treatment: A US Claims Analysis. Journal of Managed Care & Specialty Pharmacy. June 1, 2024.

Angela D. Harper, MD

Medical Reviewer

Castle Connolly Top Doctor

Angela D. Harper, MD, is in private practice at Columbia Psychiatric Associates in South Carolina, where she provides evaluations, medication management, and psychotherapy for adults.

A distinguished fellow of the American Psychiatric Association, Dr. Harper has worked as a psychiatrist throughout her career, serving a large number of patients in various settings, including a psychiatric hospital on the inpatient psychiatric and addiction units, a community mental health center, and a 350-bed nursing home and rehab facility. She has provided legal case consultation for a number of attorneys.

Harper graduated magna cum laude from Furman University with a bachelor's degree and cum laude from the University of South Carolina School of Medicine, where she also completed her residency in adult psychiatry. During residency, she won numerous awards, including the Laughlin Fellowship from the American College of Psychiatrists, the Ginsberg Fellowship from the American Association of Directors of Psychiatric Residency Training, and resident of the year and resident medical student teacher of the year. She was also the member-in-training trustee to the American Psychiatric Association board of trustees during her last two years of residency training.

Harper volunteered for a five-year term on her medical school's admission committee, has given numerous presentations, and has taught medical students and residents. She currently supervises a nurse practitioner. She is passionate about volunteering for the state medical board's medical disciplinary commission, on which she has served since 2015.

She and her husband are avid travelers and have been to over 55 countries and territories.

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Maria Masters

Author

Maria Masters is a contributing editor and writer for Everyday Health and What to Expect, and she has held positions at Men's Health and Family Circle. Her work has appeared in Health, on Prevention.com, on MensJournal.com, and in HGTV Magazine, among numerous other print and digital publications.