[Viewpoint of schizophrenic patients: a European survey]

The commercial introduction of atypical antipsychotic drugs for the treatment of schizophrenia constitutes a considerable step forward. However, despite the improved efficacy on all aspects of schizophrenia as well as improved tolerability, prescribers still appear to be reticent about substituting these agents for typical neuroleptics. With the appearance of these new drugs, the patient now occupies a central place in the management of schizophrenia. The patient is now considered as a true partner in the formulation and follow-up of the treatment programme, resulting in the need to determine the optimum therapeutic alliance. We present the results of a European survey concerning the effects of these new antipsychotic drugs comparatively with typical neuroleptics as perceived by schizophrenic patients themselves. For all patients participating in the survey, a new antipsychotic had been given in place of a typical neuroleptic for at least six months. Three-quarters of patients questioned considered that their new antipsychotic treatment would allow them to return to a normal life. Compared with the standard neuroleptics, patients felt that the new drugs had superior effects upon all dimensions of schizophrenia as well as a better safety profile, particularly as regards neurological side-effects. Because of the superior efficacy and safety profile, patients stated that they would be more inclined to follow their doctor's prescription implicitly, despite the fact that over 50% of these patients admitted to poor compliance with previously prescribed typical neuroleptics. This study focusing on the subjective experience of patients provides further arguments in support of the superiority of atypical antipsychotic drugs over typical neuroleptics, thus confirming available clinical trial data. The results of this study also pointed to the benefits of collaboration between doctor and patient, and questioning patients about their personal experience, which can then be taken into account when deciding upon and following up the therapeutic programme.