How Long Should People With Schizophrenia Take Antipsychotic Drugs?
Antipsychotic medications reduce the frequency and intensity of future psychotic episodes in patients who have recovered from an episode. Even with continued drug treatment, some people who have recovered will suffer relapses. Higher relapse rates are seen when medication is discontinued. The treatment of severe psychotic symptoms can require a higher dosages than those used for maintenance treatment. If symptoms reappear on a lower dosage, a temporary increase in dosage may prevent a full-blown relapse.
It is important that people with schizophrenia work with their doctors and family members to adhere to their treatment plan. Adherence to treatment refers to the degree to which patients follow the treatment plans recommended by their doctors. Good adherence involves taking prescribed medication at the correct dose and frequency each day, keeping all appointments, and carefully following other treatment procedures. Treatment adherence is often difficult for people with schizophrenia, but it can be made easier with the help of several strategies and lead to improved quality of life.
There are a variety of reasons why people with schizophrenia may not adhere to treatment. Patients may not believe they are ill and may deny the need for medication, or they may have such disorganized thinking that they cannot remember to take their daily doses. Family members or friends may not understand schizophrenia and may inappropriately advise the person with schizophrenia to stop treatment when he or she is feeling better.
Physicians, who play an important role in helping their patients adhere to treatment, may neglect to ask patients how often they are taking their medications, or may be unwilling to accommodate a patient's request to change dosages or try a new treatment. Some patients report that side effects of the medications seem worse than the illness itself. Further, substance abuse can interfere with the effectiveness of treatment, leading patients to discontinue medications.
When a complicated treatment plan is added to any of these factors, good adherence may become even more challenging.
There are many strategies that patients, doctors, and families can use to improve adherence and prevent worsening of the illness.
Some antipsychotic medications are available in long-acting injectable forms that eliminate the need to take pills every day. A major goal of current research on treatments for schizophrenia is to develop a wider variety of long-acting antipsychotics, especially the newer agents with milder side effects, which can be delivered through injection.
Medication calendars or pill boxes labeled with the days of the week can help patients and caregivers know when medications have or have not been taken. Using electronic timers that beep when medications should be taken, or pairing medication taking with routine daily events -- like meals -- can help patients remember and adhere to their dosing schedule.
Engaging family members in observing oral medication taking by patients can help ensure adherence as well. In addition, through a variety of other methods of adherence monitoring, doctors can identify when pill taking is a problem for their patients and can work with them to make adherence easier. It is important to voice any concerns about taking your medication to your doctor.