Good medical practice in antipsychotic pharmacotherapy

Schizophrenia requires a comprehensive treatment programme that augments pharmacotherapy, such as antipsychotic drugs, with psychological (education) and social (rehabilitation) therapies. Antipsychotic drugs, however, are still fundamental in the treatment of schizophrenia. When administered correctly, these drugs not only reduce psychotic symptoms but can also prevent relapse, which prevents hospitalization and facilitates psychosocial re-integration. Unfortunately, the type of drug and dosing schedule used are often inappropriate. The antipsychotic drug prescribed should be decided on an individual patient basis according to the experiences the patient has had with previous treatments. Choosing the right drug is a key to improving compliance and treatment outcome. Additionally, antipsychotic drugs should be prescribed at an early stage, in order to increase the likelihood of a favourable treatment outcome, and for long enough to reduce the risk of relapse. The efficacy and tolerability of antipsychotic drugs have been studied extensively, and treatment guidelines have now been developed, in particular from the Bruges Consensus Conference and the American Psychiatric Association, to optimize the diagnosis and treatment of schizophrenia. The use of novel antipsychotics, which have better therapeutic and safety profiles than traditional antipsychotics, together with educational programmes should improve compliance with antipsychotic drugs and thus improve treatment outcomes for schizophrenic patients. Treatment strategies to be used at the various stages of schizophrenia have been recommended, together with preferred options for managing lack of response or side effects.