ATYPICAL ANTIPSYCHOTIC AND COMPLIANCE IN SCHIZOPHRENIA

Relapse of schizophrenia due to poor compliance is a major preventable source of psychiatric morbidity. One often stated reason for non-comp liance is side effects from the conventional neuroleptics. Minimum eff ective doses are known from most drugs minimizing side-effects but low -dose maintenance regimes below these minimum doses lead to relapse. T he advantages of depot medication in ensuring compliance are clearly u nderstood, but the use of depots varies enormously in different countr ies. In the longer term, it is hoped that new atypical neuroleptics ma y have several intrinsic advantages which maximize patient compliance. Atypical neuroleptics fall roughly into five groups, the later substi tuted benzamides, mixed dopamine-serotonin receptor antagonists, speci fic dopamine compounds, serotonin receptor antagonists and sigma recep tor antagonists. There are some early indications of improved complian ce with an atypical neuroleptic, clozapine, but it is difficult to dis entangle the potential massive effect of the monitoring system used in controlled studies. There is still no evidence that the new atypical neuroleptics could substantially improve the compliance in comparison with for example depot neuroleptics.