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Pharmacological Strategies to Enhance Adherence in Schizophrenia

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Adherence to Antipsychotics in Schizophrenia

Abstract

In schizophrenia, poor adherence to antipsychotic treatment limits its effectiveness and results in an increased risk of relapse, rehospitalization, and antipsychotic treatment resistance. Further, nonadherence and partial adherence have been associated with substance use, violence, arrests, suicide attempts, and poorer long-term functioning. Based on a sound therapeutic alliance between healthcare professionals and patients, which is known to play a key role in patients’ attitudes toward treatment and cooperativeness of taking medication as prescribed, pharmacological strategies to enhance adherence include the choice of drugs that allow maximum efficacy and minimal side effects, monotherapy, and the prescription of a one-daily dosage regimen. The type of oral antipsychotic treatment (first- versus new-generation compounds) does not seem to have an appreciable impact on the level of medication adherence. Long-acting injectable antipsychotic medication clearly does not in itself ensure adherence, but it has obvious advantages such as assured medication and the awareness of when a patient has stopped treatment, which allows the opportunity for appropriate, prompt intervention.

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  1. Psychiatry and Psychotherapy, Biological Psychiatry Division, Medical University Innsbruck, Innsbruck, Austria

    Alex Hofer & Wolfgang Fleischhacker

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Hofer, A., Fleischhacker, W. (2014). Pharmacological Strategies to Enhance Adherence in Schizophrenia. In: Adherence to Antipsychotics in Schizophrenia. Springer, Milano. https://doi.org/10.1007/978-88-470-2679-7_2

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