The most common symptoms of psychosis are:4

• Hallucinations - hearing, seeing or feeling things that aren’t there
• Delusions – having a strong belief in something that no-one else believes
• Disorganised thinking and speech – not being able to think straight or communicate clearly

Antipsychotics aren’t a cure for schizophrenia, but they can usually help to reduce the symptoms of psychosis. This can make the symptoms easier to deal with.3

There are lots of different types of antipsychotic drug. If you find that you don’t get on with a particular drug, talk to your doctor or specialist nurse to see if there’s anything else you could try, or any ways that you could make your medication work better for you.3

There are two broad types of antipsychotic medication, and they can be called a number of different things:2

The first generation antipsychotics are also referred to as “older” or “typical” antipsychotics. They were invented first. They all work in similar ways, and cause similar side effects, but they’re not all exactly the same.3

Second generation antipsychotics may be called “newer” or “atypical” antipsychotics. They were invented after the first generation of antipsychotics. They tend to cause slightly different side effects to the older/typical antipsychotics: they are less likely to cause muscle problems like stiffness, weakness or shaking, but more likely to cause weight gain, for example.2,3

No-one knows exactly why antipsychotic medications work. We have a few ideas about how they probably work, but we haven’t been able to pinpoint the exact mechanism. This is called a hypothesis. At the moment, scientists are working with the hypothesis that antipsychotic medications affect the dopamine in your brain.2 Dopamine is a substance that all humans have, but in schizophrenia it’s thought that there may be some kind of imbalance of dopamine.5 We don’t have any proof of the dopamine hypothesis, but we do have evidence:

Proof: something that shows a hypothesis is definitely true or untrue

Evidence: something that suggests a hypothesis is true, but isn’t enough on its own to say for definite

There are a lot of different antipsychotic medications, and they can take a number of different forms. The form a medication takes will influence how quickly it gets into your system and how long its effects will last. If you don’t get on with one form, or one medication, talk to your healthcare team to see if there is an alternative. The common forms of antipsychotic medication available at the moment are:3

• Tablets
• Dissolving tablets
• Capsules
• Liquid drops
• Long-acting injection
• Emergency injection
• Suppositories

It’s important to remember that no medication works 100% of the time for absolutely everybody. If you are taking one medication and you find that it’s not helping your symptoms enough and/or you’re getting side effects that are too much to handle, talk to your doctor or specialist nurse. There are lots of other options to try.1,3

Healthcare professionals will choose to prescribe a particular medicine for a number of complex reasons. Just because someone you know liked or did not like a particular medication, it doesn’t mean it will or will not work for you. The things prescribers take into consideration when deciding on a medication include:1,6,7

• What medications you’ve tried before
• If there are any drug types you can’t tolerate (i.e. they make you ill)
• What kind of symptoms you’ve been experiencing (e.g. positive, negative or psychotic)
• How severe your symptoms have been, both now and in the past
• Your physical health, including your weight, blood pressure, diet etc.
• Whether you’ll be taking your medication at home by yourself, or in a healthcare facility
• What you and your doctor hope to achieve with the medication
• What other medications you’re taking
• Any other health conditions you have
• What is known about each medication and its side effects

When people take a medication exactly as it’s prescribed by a healthcare professional, that’s called adherence. It means sticking to the schedule and taking every dose when it’s due, for as long as it’s prescribed.

Adherence is not as easy as it sounds, though. It’s not just a case of remembering to take the medication. There are all sorts of complex factors that can make adherence more difficult8

Even a highly effective drug can’t do anything for you if it’s still in the packet. For most medicines to work well they have to be taken at regular intervals.8 This keeps a certain amount of the active drug in your system at any one time. If you miss a few doses, you won’t have the right amount of medication in your body at the right time.9 This can mean that your symptoms aren’t controlled anymore, and you may end up having to go back to your doctor, or even be admitted into hospital.9,10

Why adherence is difficult – and some ideas for what you can do about it