Compliance and the rehabilitation alliance

Expectations for the treatment of schizophrenia have historically been modest, with emphasis on eliminating positive symptoms and keeping patients out of the hospital. Noncompliance with traditional antipsychotic agents, which have limited efficacy and are associated with numerous adverse side effects, has contributed to these low expectations. The atypical antipsychotics can improve compliance because of their better safety, efficacy, and tolerability and thus help raise treatment expectations from mere removal of symptoms to fuller rehabilitation. This rehabilitation can even include the reintegration of patients with schizophrenia into the community. Compliance with any drug regimen, however, does not in itself guarantee the return to a normal life for patients with schizophrenia. Instead, compliance must occur within a rehabilitation alliance--a supportive network that includes the patient, the treating physician, family members and friends, and other caregivers.