Psychofarm Podcast Choosing Antipsychotics in Schizophrenia: Side-Effects, Maximizing Efficacy, and Finding the Right Medication | Episode 17
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Feb 26, 2025 A lively conversation about how to pick antipsychotics for schizophrenia, weighing metabolic risk, sedation, akathisia and tardive dyskinesia. They compare drugs by weight gain potential, discuss dosing and timing to reduce side effects, and debate long‑acting injectables versus oral options. Practical tips cover when to switch medications, avoiding unnecessary anticholinergics, and strategies to improve adherence.
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Dose Once Daily At Night
- Schedule antipsychotics once daily at night to reduce daytime sedation and improve adherence.
- If a drug peaks late (e.g., olanzapine), time it earlier in the evening to avoid morning grogginess.
Center Treatment On Patient Goals
- Engage patients in shared decisions and target treatment to improve functioning rather than eliminate every symptom.
- Ask what symptoms the patient finds distressing and prioritize those goals.
Plan For Akathisia Proactively
- Balance metabolic/sedation risks against akathisia/EPS risk when selecting antipsychotics.
- Offer PRN benztropine or propranolol for akathisia and treat promptly rather than ignoring symptoms.
