Antipsychotic side-effect - potential risk of patients rejecting their treatments

Antipsychotics side-effects pose an enormous problem in psychiatric treatment. The choice of antipsychotics is a crucial issue in the treatment as both patients' cooperation and compliance often depend upon it. Severe side-effects might sometimes cause the treatment interruption, to which each patient is entitled. Schizotypal personality disorder (SPD) features include social and interpersonal deficits, discomfort with close relationships, as well as cognitive and perceptual distortions and eccentricities of behaviour. Dominant symptoms often determine psycho pharmacotherapy and therefore antipsychotic treatment is possible. A 23 year-old man was treated for 4 months due to disturbances typical for SPD. Since the patient did not respond well to haloperidol, zuclopenthixol was advised. The latter medication produced severe, life-threatening side-effects which caused urgent hospitalisation. Althouth zuclopenthixol was instantly retracted from the therapy, the patient and his family rejected any further psychiatric treatment. In spite the fact that hetero-data obtained from his mother a few months later, revealed disturbances which greatly affected the patient's live, the patient showed resistance to further psychiatric treatment because of his negative experience with this medication.