Poor social and interpersonal skills can prevent people from interacting effectively with other people. Antipsychotics can improve the symptoms of schizophrenia, and can also improve social functioning.

What is the evidence for medications for social functioning?

Moderate to high quality evidence (in order of descending effects, first being best), found improvements in social functioning with thioridazine, olanzapine, paliperidone, quetiapine, lurasidone, and brexpiprazole compared to placebo. There were no improvements in social functioning with aripiprazole, sertindole, amisulpride, ziprasidone, flupentixol, and risperidone

For side effects (in order of first being best), there was a large effect of less use of antiparkinson drugs with clozapine, and more use of antiparkinson drugs with paliperidone, ziprasidone, risperidone, lurasidone, zotepine, cariprazine, chlorpromazine, sulpiride, perphenazine, molindone, zuclopenthixol, trifluoperazine, flupentixol, haloperidol, loxapine, penfluridol, fluphenazine, chlorpromazine, thiotixene and pimozide. There was more akathisia with aripiprazole, ziprasidone, thioridazine, asenapine, amisulpride, chlorpromazine, thiotixene, risperidone, cariprazine, loxapine, haloperidol, lurasidone, trifluoperazine, sulpiride, molindone, penfluridol, pimozide, fluphenazine, flupentixol, and zuclopenthixol. There was more weight gain with haloperidol, amisulpride, asenapine, risperidone, paliperidone, clozapine, quetiapine, iloperidone, chlorpromazine, sertindole, olanzapine, and zotepine. There was less prolactin elevation with aripiprazole, clozapine, and zotepine, and more prolactin elevation with olanzapine, asenapine, lurasidone, sertindole, haloperidol, amisulpride, risperidone, and paliperidone. There was more sedation with aripiprazole, lurasidone, haloperidol, risperidone, asenapine, loxapine, olanzapine, chlorpromazine, thioridazine, thiotixene, ziprasidone, perazine, clozapine, clopenthixol, quetiapine, sulpiride, zotepine, and zuclopenthixol. There was more QTc prolongation with quetiapine, olanzapine, risperidone, iloperidone, ziprasidone, amisulpride, and sertindole.

October 2020

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