Nonadherence to medications is a significant problem; in a recent study, 74 percent of patients discontinued their medication within 18 months. 16 Nonadherence often leads to relapse of symptoms. Atypical antipsychotics were initially thought to help with adherence because of their lower rate of neurologic side effects. However, meta-analyses have found that drop-out rates and relapse prevention are no better with atypical antipsychotics than with neuroleptics. 17 , 18 Meta-analyses also have found that in terms of symptom scores and drop-out rates, atypical antipsychotics are better than high dosages (., more than 12 mg per day) of haloperidol (Haldol); there was no advantage when the dosage of haloperidol was less than 12 mg per day. 17 In other words, many of the perceived benefits of atypical antipsychotics actually were a result of the excessive doses of first-generation antipsychotics that were used for comparison in randomized trials. 17 Evidence suggests that delays in initiating therapy with antipsychotics may result in a lifetime deleterious effect on psychotic episodes and social adjustment. 19 , 20 If initiation of antipsychotic therapy is delayed because of limited psychiatric resources, family physicians should consider starting medications instead.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.