Optimizing Management of Schizophrenia with LAIs - Episode 7

Challenges With Oral Antipsychotics for Schizophrenia

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Transcript: John M. Kane, MD: Currently, most patients with schizophrenia are receiving oral medication. Sanjai, what would you say are the biggest challenges that you face?

Sanjai Rao, MD: There are a number of challenges related to individual medications and their particular [adverse] effects. The first one is the challenge of adherence. There is literature suggesting that people with schizophrenia do not take their medications for any length of time. Depending on the measure you look at, around half of them will stop medications after 6 months, maybe three-fourths of them or close to that, will stop between 1 and 2 years. It’s important to realize that before we identify this as a problem with mental health, that having a cognitive problem like schizophrenia, mental health issues are contributing factors. But this also occurs in nonpsychiatric medical illness. Comparing adherence rates for chronic medical illness, such as diabetes, hypertension or hyperlipidemia, they're not as bad as what we see in schizophrenia, but they're not great either.

A substantial portion of those patients will stop their medications, and they'll stop them for many of the same reasons that our patients with schizophrenia will describe that they're stopping. They forgot or they don't have a routine. With acute treatment, many of us will not take entire courses of antibiotics.

This is a problem that is pronounced in mental health, but not unique to mental health. It's a challenge for all medical treatment, but especially for us in mental health.

Transcript Edited for Clarity