Importance of Staying on Treatment

Staying on medication

Compliance is a medical term that means taking medications the right way – exactly as prescribed by the healthcare professional. The right dose at the right time.

One of the biggest risks of noncompliance is relapse. Study after study shows that relapse rates and rehospitalizations are far higher when medication is discontinued.

Even partial compliance – taking medication sporadically or every other day, and frequently missing doses – can lead to decreased functioning and breakthrough symptoms long before a full relapse occurs. In most cases, the relapse occurs weeks to months after a patient stops taking their medication. This can be incredibly disruptive and discouraging after the patient's symptoms have been stabilized. Of course the downside of relapse is that the more relapses a patient has, the worse their functioning may become.

Because people with schizophrenia who take their medication regularly are less likely to relapse, it is very important that they work with their doctors and caregivers to comply with their treatment plan.

Why staying on medication can be difficult

Following a daily medication ritual is difficult for anyone. There are many reasons why people with schizophrenia have difficulty staying on their medication. The cause might be completely accidental – a simple matter of forgetting, or of taking the wrong dose by mistake. Even if they keep their pills sorted in a pillbox, they may not always remember to take them. Most people have trouble even taking a 10-day course of antibiotics as prescribed.

Not taking medication may also be deliberate. Some people have strong feelings about taking drugs that affect the way they feel, think, and act. So they may stop taking them for the following reasons:

Patient-Related Factors

• Person denies having schizophrenia

• Person doesn't think the medication is working

• Person has substance-abuse problems

• Person resists authority and being told what to do

• Person fears becoming “addicted” to antipsychotic drugs

• Disorganized thinking and cognitive impairment caused by the illness

• Person feels too good to need the drug

• Person feels stigmatized by having to take antipsychotics daily – perceives it as being “crazy” or a sign of weakness

Medication-related factors

• Side effects of medication are bothersome
• Doesn't seem to be helping with symptoms

Environmental factors

• Family members may advise the person to stop treatment when feeling better
• Inadequate support or supervision

Regardless of the reason, the fact is that up to two-thirds of patients with schizophrenia fail to take their antipsychotic medication as prescribed, and within two years after hospital discharge, 75% of patients are only partially compliant.

Having to constantly remind your friend or relative to take their medication can be stressful. Sometimes caregivers will ignore the issue, because they are afraid of provoking worse symptoms or getting into arguments with the sufferer and increasing family tensions.

However, the symptoms won't go away by themselves. In order to prevent relapse, medication must be taken as prescribed. Relapse is a significant worsening of symptoms which can lead to hospitalization.

Helping your friend or relative stay on medication

Unfortunately, there is no “cure” for schizophrenia, but, like arthritis and hypertension, it can be controlled by medication. For most people with schizophrenia, long-term medication is a fact of life. Even when your friend or relative improves on medication, they will still have to take it to remain better.

They will also have to take their medication exactly as prescribed once a day, perhaps even the same time each day, year after year -- which can prove challenging for you to motivate them.

However by encouraging your friend or relative to continue treatment and assisting them in the process you can positively influence their improvement and help them live a more fulfilling life.

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