Patient satisfaction after switching from conventional to new atypical antipsychotics in schizophrenia

To study the satisfaction and subjective experiences of patients with schizophrenia after switching from a conventional to a new atypical antipsychotic, and the relationship of patient satisfaction to clinical improvement

Seventy-four chronic schizophrenia (DSM-IV) patients in a naturalistic setting whose response to a conventional antipsychotic was unsatisfactory (clinical improvement or intolerance of side-effects) switched to olanzapine or quetiapine or risperidone. After 3 months, patients completed a seven-item Patient Satisfaction Questionnaire, and a psychiatrist assessed the clinical global improvement.

Forty-five (61%) of the patients were either very or extremely satisfied with the new medication and 47 (63.5%) rated it very or extremely helpful; 35 (47%) of the patients reported no side-effects. Fiftyone (69%) indicated that they preferred the new medication to previous therapy: better tolerability was given as the reason by 40 (54%) patients. Fifty-eight (78%) patients perceived a general improvement in their quality of life. Slightly fewer patients reported improvement in their symptoms and their daily living activities. Over 75% of patients expressed readiness to continue the new medication. Significant association between clinical response and patient satisfaction was demonstrated by only a small subgroup of patients.

In the majority of schizophrenia patients, administration of new atypical antipsychotics seemed to result in higher levels of patient satisfaction than did conventional drugs. This had a favourable effect on the patients' attitude to the new medication, which may improve compliance. More patients perceived benefits related to quality of life than to efficacy. Clinical improvement was an important, but not the sole, determinant of patient satisfaction with medication.