Long-term considerations after switching antipsychotics

The so-called "atypical" antipsychotics are rapidly becoming the de facto s tandard pharmacologic treatment of schizophrenia. This article reviews some common psychopharmacologic and psychological issues that may arise after a n outpatient with schizophrenia is switched to one of the newer antipsychot ics. Important issues to consider in the first few months after switching i nclude assessment of response to the new medication, dealing with subsequen t psychological reactions, and management of an unsatisfactory response. On ce the response is established, there are other pharmacologic and psycholog ical issues that arise during the next year or two. Pharmacologic issues th at emerge later on include the role of long-term combination antipsychotics , management of new side effects, and deciding whether and when to switch a gain. Some of the long-term psychological issues include changes in self-im age that arise from being less visibly ill, sexuality and intimacy concerns , and recovery issues.