How important are informed consent, informed choice, and patient-doctor relationships, when prescribing antipsychotic...

Antipsychotic medications (APs) are used for people with psychosis diagnoses and, increasingly for other problems and groups.

This study examines how APs are prescribed, from the perspective of recipients.

757 people, from 30 countries, responded to questions about their experiences with APs, in an online survey.

Most (70%) were told nothing about adverse effects. Fewer than 2% recalled being told about the risks of diabetes, suicidality, sexual dysfunction, or reduced life span. None recalled being told about reduced brain volume or withdrawal effects. Only 28% recalled being offered other treatments; with only 14% offered talking therapies. 46% were not told how long to take the APs; and, of those who were told something, 48% were told to take them forever. Most respondents (76%) were not told how APs work. Only 19% were satisfied with the prescribing process, and only 25% reported a good, or very good, relationship with the prescriber. Information, satisfaction with the process, and the prescriber relationship were all positively related to three self-reported outcomes: reduction of problems the drugs were prescribed for, general helpfulness, and quality of life.

Steps need to be taken to ensure people prescribed antipsychotics are fully informed, especially about adverse effects and alternatives.