Antipsychotics are one of the main tools used to treat schizoaffective disorder. For some people, they reduce hallucinations, stabilize mood, and make life more manageable. For others, they cause side effects that feel just as disabling as the illness itself.

This chapter doesn’t glorify or demonize meds. It’s about survival.

🔹 What Antipsychotics Do

Antipsychotics work by altering brain chemistry—mainly by reducing dopamine activity. They’re usually prescribed to treat:

  • Hallucinations

  • Delusions

  • Disorganized thinking

  • Mania

  • Severe mood instability

There are two main types:

  • First-generation (typical) – older, often harsher side effects

  • Second-generation (atypical) – newer, often better tolerated but not always

They can be taken daily (pills) or every few weeks/months (injectables).

🔹 Common Side Effects

Even when antipsychotics help, the side effects can be brutal. These include:

  • Weight gain and appetite changes

  • Sedation and mental fog

  • Emotional flattening

  • Tremors, stiffness, and restlessness (akathisia)

  • Sexual dysfunction

  • Metabolic issues (diabetes, cholesterol)

  • Feeling “numb” or “not yourself”

🔹 Why People Stop Taking Them

  • The side effects feel worse than the symptoms

  • They miss the emotional or creative highs of unmedicated states

  • They feel disconnected, flattened, or dead inside

  • They don’t trust the diagnosis or treatment plan

  • They want to try managing without meds

  • They’re forced to take them and resist the loss of control

These are all valid feelings. And many people go through cycles of stopping, restarting, or switching.

🔹 Making Medication Work For You

If you choose (or are required) to take antipsychotics, here are ways to reduce harm and increase benefit:

➤ Track your reactions

Note how you feel on each dose—physically, emotionally, cognitively. Bring this to your prescriber.

➤ Don’t settle for the first one

It’s common to try several meds (and combos) before finding one that works. Keep going until it feels livable.

➤ Request regular med reviews

You deserve time to discuss side effects, symptoms, and adjustments—not just quick refills.

➤ Build support around it

Medications often work better alongside therapy, structure, sleep, and peer support.

🔹 What If You Want to Stop?

Going off antipsychotics is serious and should be done slowly, with support. Stopping cold turkey can trigger rebound psychosis or withdrawal symptoms.

If you're considering stopping:

  • Talk to a provider about tapering

  • Have a safety plan and supports in place

  • Track changes in mood, thinking, sleep, and perception

  • Don’t do it alone—ask someone to help monitor you

Some people live without antipsychotics. Others return to them after trying to stop. There’s no one right way.

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