Simona Manuela Bida, Cosmin Bida, Teona Tudorici, Roxana Chirita
Abstract
Schizophrenia is a chronic, debilitating psychiatric disorder characterized by a wide spectrum of positive, negative, and cognitive symptoms that impair social and occupational functioning. Pharmacological treatment remains the cornerstone of management, with antipsychotic medications playing a central role in symptom control and relapse prevention. This review explores the current landscape of antipsychotic therapy, analyzing the efficacy and safety profiles of first- and second-generation agents, the growing use of long-acting injectables, and the persistent challenges related to adherence and long-term outcomes. While second-generation antipsychotics have expanded therapeutic possibilities, issues such as metabolic side effects, residual negative symptoms, and treatment resistance continue to limit functional recovery. The discussion highlights the importance of individualized treatment strategies, the integration of pharmacological and psychosocial approaches, and the role of emerging therapies and digital tools. Future directions point toward precision psychiatry, novel pharmacological targets, and systemic efforts to reduce disparities in access and care quality. Overall, optimizing the pharmacological management of schizophrenia requires a patient-centered, multidisciplinary approach that addresses both clinical complexity and real-world barriers to recovery.
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