What is considered the first-line treatment for schizophrenia?

The first-line treatment for schizophrenia is atypical (2nd generation) antipsychotics. These medications are preferred due to their efficacy in treating both positive symptoms, such as hallucinations and delusions, and negative symptoms, such as apathy and social withdrawal. Atypical antipsychotics tend to have a more favorable side effect profile compared to typical antipsychotics, with a lower risk of extrapyramidal symptoms, which can be significant with the older medications.

Additionally, atypical antipsychotics have been shown to be effective in improving overall functioning and quality of life for individuals with schizophrenia. They also have a lower potential for causing tardive dyskinesia, a serious and sometimes irreversible movement disorder associated with long-term use of typical antipsychotics.

In contrast, typical antipsychotics, while effective for some patients, do not address the negative symptoms as effectively and carry a higher risk of neurological side effects. SSRIs, which are primarily used to treat depression and anxiety disorders, are not effective for the core symptoms of schizophrenia, and MAO inhibitors are not standard treatments for this condition.