It’s no secret to those of us that work in the mental health arena that schizophrenics often relapse to the active, observable symptoms of schizophrenia (delusions, hallucinations, exaggeration, disorganization) due to medication non-compliance. The three primary reasons for this are as follows:

  1. In an active psychotic state, non-compliance is fueled by paranoia – which dictates that medication is some form of poison or mind control. Why take poison, or something that will manipulate the mind?
  2. Another piece of the schizophrenic’s thought puzzle is that medication has curative powers. Medication is supposed to “fix” the problem isn’t it? Numbers 1 and 2 are of course, influenced by poor reality testing which in turn leads to illogical conclusions.
  3. Antipsychotics are fraught with side effects. This is true, and there is nothing irrational or illogical about giving up on medication that causes weight gain, marked sedation, type – II diabetes, the potential for rising levels of cholesterol and triglycerides and movement disorders. Non-compliance due to side effects I can understand, these medications are just plain awful for the most part.

Regardless of the reasons, the risks of antipsychotic non-compliance have to be addressed. Continued relapse to active psychotic features is a recipe for potentially serious consequences for both the schizophrenic and his/her family. This is why it is so important to get the family involved in treatment. Family members are our de-facto healthcare specialists and are the clinician’s first line of defense against symptom re-emergence. Those closest to the affected individual should be made aware of the therapeutic benefits of medication as well as the adverse effects. Consistently, family members prove to be the clinician’s most reliable ally when it comes to challenging the schizophrenic’s irrational beliefs regarding medication and increasing medication compliance. Use them!