Abstract
When patients are nonadherent to their antipsychotic therapy, their risk for relapse and disease exacerbation is greatly enhanced. These events may necessitate rehospitalization and may significantly increase the cost of care. Improving the propensity of patients to adhere to their regimen requires an assessment of patient attitudes and expectations concerning their medication and, if necessary, appropriate education. In addition, healthcare professionals need to foster therapeutic alliances by decreasing threats and avoiding the use of depot medications as a “punishment” for nonadherence. The type of medication may even influence the potential for improved adherence. Available data suggest that oral atypical antipsychotics offer the lowest potential for nonadherence and relapse, followed by depot conventional and oral conventional antipsychotics. The first long-acting atypical antipsychotic, an injectable preparation of risperidone, is anticipated soon. This drug will offer the efficacy and safety benefits of an atypical antipsychotic, with a much more stable pharmacokinetic profile than oral medication. Such medications may represent the next step in improving patient adherence to an antipsychotic regimen. Healthcare professionals need to understand that treatment nonadherence is human nature and not a result of mental illness. Only then can an effective and caring solution be implemented.
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