How long will the medicine take to work for schizophrenia? How long will it be before a change is considered?
You need to refer to the answer on antipsychotic medication below
Before going onto another medicine, it is worth trying to get the best out of the first one. There is a risk that switching medicines too quickly means you don’t get the best out of one medicine. Then perhaps you start to search for the “magic bullet”, expecting the drugs to work quicker and having less patience. There are of course no “magic bullets”. Most symptoms have started to happen over a few weeks, months or years, not a few days, so it is perhaps unfair to expect them to go over a few days. The symptoms are more likely to go gradually over weeks or months. If side effects are the main problem with a medicine, try to cope with these by e.g. changing times, splitting the dose, manage side effects etc.
The best thing to do is set out your aims of success of any treatment in advance and be realistic. If you decide to stop, then that’s your decision, but make sure you consider the chances of becoming unwell again (and consequences of that to yourself and the people close to you).
First episode:
If someone’s symptoms have not improved after about two weeks and isn’t getting too many side effects, then usually the dose should be increased. If no better at four weeks at a good dose, then usually switching to another antipsychotic is the best plan. If the person is getting side effects they can’t cope with then it may be a good idea to switch to another antipsychotic a bit earlier.
Acute psychosis
If someone is suffering from an acute psychosis, most people will start to improve within in 3-4 weeks at the latest. Often the symptoms will reduce in a few days. If there has been no improvement over 6-8 weeks, then increasing the dose further is unlikely to help. It may take a while to find the right dose, which gives the right balance betweem effect and side effects. If the person hasn't improved at all after 2 weeks this means the medicine is highly likely not to work after 2 weeks (O'Gorman 2011).
Clozapine can only be used for “treatment-resistant schizophrenia” that has not got better with two other antipsychotics taken at the right dose for enough time. If no improvement occurs after 3 weeks at any dose of clozapine, it is unlikely to be any better at that dose, but some studies have shown a gradual improvement accumulating over 6 months or longer.
Updated 5.12