Strategies for increasing treatment compliance: the role of long-acting antipsychotics

Increased patient compliance with antipsychotic medications is associated with increased efficacy and reduced rates of rehospitalization. It can improve treatment outcomes for patients and reduce costs for society. An understanding of the reasons for noncompliance is essential in formulating strategies to provide better health and economic outcomes. Time-tested strategies such as addressing adverse effects, educating patients, and forming patient-provider alliances with those receiving medications can have a dramatic impact on compliance. Depot antipsychotics have been the mainstay of treatment for patients with schizophrenia who are known to be noncompliant. These agents are especially effective when combined with social support. Atypical antipsychotics, with their improved efficacy and tolerability, appear to increase compliance and reduce rehospitalization compared with conventional oral and depot agents. A new long-acting formulation of an atypical antipsychotic agent combines the advantages of depot drugs and atypical agents. However, such a drug also poses challenges in the changing setting of community mental health. These challenges present pharmacists with an opportunity to assume new roles in the management of patients requiring antipsychotic therapy.