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J Clin Psychiatry. 2013 Oct;74(10):e21. doi: 10.4088/JCP.12117tx2c.

Monitoring treatment and managing adherence in schizophrenia.

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From the Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine; VA Desert Pacific Mental Illness Research, Education, and Clinical Center; and the Semel Institute, University of California, Los Angeles.


The majority of patients with schizophrenia will be nonadherent at some point during their treatment, which is why clinicians must assess adherence at each visit and promptly address any barriers. Treatment adherence can be negatively impacted by substance use, cognitive impairment, complex treatment regimens, and antipsychotic-induced adverse effects. Clinicians must monitor these risk factors, particularly metabolic, neurologic, and other side effects, not only to improve adherence but also to protect patients from dangerous health conditions. Interventions that can address some barriers to treatment adherence include adjusting medications as necessary, implementing lifestyle changes, using long-acting injectable antipsychotics, educating patients and their families, and implementing psychosocial therapy. With the appropriate interventions and support, patients with schizophrenia can maintain their treatment regimens and avoid relapse.

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