Examples

• chlorpromazine (Largactil),
• flupentixol (Fluanxol), 
• haloperidol (Haldol),
• loxapine (Loxapac), 
• zuclopenthixol (Clopixol) 
    

What are typical antipsychotic medications used for? 

Typical antipsychotics are a type of medication used to treat conditions that involve psychosis. Psychosis is when someone experiences a change in the way they see reality. This can make it difficult to carry out daily activities. Typical antipsychotics can reduce psychotic symptoms and make it easier to think clearly and stay connected to reality. 

Sometimes typical antipsychotics are used to treat agitation, which means feeling very restless, upset or irritable. This medication may not work as well for mood changes, such as depression. If you have mood-related symptoms, talk with your prescriber about the best medication options. 
  

How do they work? 

Typical antipsychotics restore the balance of brain chemicals, especially one called dopamine. Taking this medication as prescribed reduces the chance that symptoms will return. This medication works best when it is combined with other support, such as counselling. 

Some people are treated with a newer group of medications called atypical antipsychotics. These medications also affect dopamine, as well as other brain chemicals, such as serotonin. 
  

How are they taken? 

Depending on the type of antipsychotic, it can be taken as a pill by mouth or it can be injected with a needle into the muscle. Antipsychotics that can be injected are flupentixol, haloperidol and zuclopenthixol. Injections are usually given every two to four weeks. They work as well as antipsychotics taken by mouth. Injections can be more convenient than taking medications by mouth every day. 
  

How long do they take to work? 

Some symptoms may improve within two weeks of starting the medication. However, it can take four to eight weeks at the right dose to see the full benefit. If you do not feel even a minor improvement after eight weeks, the medication may not be the right one for you. Talk with your prescriber about whether another medication might work better. 
  

How long do I have to take these medications for? 

The length of treatment depends on many factors, including your diagnosis. If you want to make changes to your medication or would like to stop taking it, talk with your prescriber first. 
  

What happens if I miss a dose? 

If you forget to take a dose, take it as soon as you remember, unless it is almost time for your next dose. If it is close to your next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses at the same time. If you are not sure what to do, ask your pharmacist. 
  

What are potential side effects? 

All medications can cause side effects, but each person may have a different experience. You may not have any side effects at all. Some typical antipsychotics are more likely to cause certain side effects. 

Your prescriber will work with you to choose the best medication for you, so you can continue your daily activities and enjoy life. 

Some possible side effects are listed in the table below. If you experience any side effects, it is important to tell your prescriber. The table also describes things you can do to reduce or cope with side effects. 
  

Potential Side Effects of Typical Antipsychotic Medications  

Movement effects

Some movement effects start within days to a few weeks of starting a new typical antipsychotic or increasing the dose. Here are some examples:

• Parkinsonism: slowed movements (like walking slowly or dragging your feet), shaking or tremors (usually in the hands or arms), or stiffness
• Dystonia: cramping or uncontrolled flexing of the muscles
• Akathisia: feeling restless or jittery, which makes it hard to sit still or not move around a lot Other movement effects can happen after a longer period of taking this medication:
• Tardive dyskinesia: body movements that you cannot control, such as smacking your lips, sticking your tongue out, making faces (like frowning), moving your fingers (like playing a piano), or rocking your hips back and forth.
    

Metabolic effects

Examples: weight gain, high blood sugar, high cholesterol

Weight gain typically occurs within 12 weeks of starting a medication.

• Do regular physical activity.
• Make healthy food choices:
  • Eat plenty of vegetables, fruit, whole grains and protein.
  • Limit highly processed foods.
  • Drink water instead of sugary drinks.
• Consider talking with a dietitian, or check out Canada’s Food Guide for healthy, budget-friendly eating tips (https://food-guide.canada.ca)
• Schedule regular doctor appointments to check your weight, blood sugar and cholesterol.  
    

Potential Side Effects of Typical Antipsychotic Medications  

Sedation

Examples: feeling sleepy or groggy, having low energy

Some people experience sedation when they start a typical antipsychotic or increase the dose. It usually goes away with time. Here are things you can do to cope and stay safe:

• Try taking the medication at bedtime.
• Do not drive or do activities that need you to be alert if you feel sleepy or groggy.
    

Hormonal effects

Examples: decreased sex drive/function, missed periods, discharge from breasts

Tell your prescriber if you have these side effects because there may be ways to reduce them.
  

Other side effects

Dry mouth:

• Drink plenty of water.
• Try sucking on sugarless lozenges or chewing sugarless gum.
• Talk with your dentist about how to manage dry mouth.

Difficulty urinating:

• Talk with your prescriber to see if there are ways to reduce this problem.

Constipation:

• Drink plenty of water and eat high-fibre foods such as vegetables, fruit and whole grains.
• Talk with your pharmacist about trying laxative medication.

Dizziness or feeling lightheaded:

• Get up slowly if you are sitting or lying down. Sit down if you feel dizzy.
• Stay hydrated.  
    

Can side effects be serious? 

There is a rare and serious side effect called neuroleptic malignant syndrome. It can occur even if you have been taking the medication for a long time. Go to the nearest emergency room if your muscles feel stiff, you have a fever of 38 °C or higher, your blood pressure changes suddenly or you feel confused or sleepy. 
  

Are there drug interactions I should be aware of? 

Some medications don’t work well if they are taken together. This drug interaction can happen between typical antipsychotics and certain medications. Talk with your prescriber or pharmacist before you start any new prescription medications, over-the-counter medications or natural health products, such as vitamins or herbal remedies. 
  

Is there anything else I should be careful about? 

Typical antipsychotics can make it harder for your body to control its temperature. This means that you should avoid very hot weather and drink a lot of water. 
  

Is it safe to use these medications during pregnancy? 

If you are pregnant or thinking of becoming pregnant, talk with your prescriber about your medication. It is important to take care of your mental health during pregnancy and a typical antipsychotic may help. You and your prescriber can talk about the risks and benefits of using this kind of medication during pregnancy. 
  

What else can I do to support my recovery? 

• Substances such as street drugs, alcohol or cannabis can cause drowsiness or make it harder to get well. Talk with your health care team about substance use and how they can support you. 
• Consider trying other treatments such as counselling.  
• Stay connected with your prescriber or treatment program, and ask for help when you need it.