Antipsychotic Medications, Schizophrenia and the Issue of Quality of Life

Abstract

Schizophrenia as a long term disabling illness generally runs a chronic course with acute psychotic relapses that frequently requires hospitalizations. Antipsychotic medications have emerged as the cornerstone in treatment of the disorder in addition to other important interventions such as rehabilitation, psychosocial and economic support. Unfortunately antipsychotic medications has presented a number of significant limitations in terms of inconveniencing or serious side effects as well as there inability to improve certain symptoms at different stages of the illness. 30{%} to 50{%} of patients on antipsychotic medications develop serious dislike to medication as a result of becoming dysphoric, a situation that lead to compromised adherence to medications and subsequent relapse and compromised quality of~life. ∈dent Reviewing published studies involving both new and old antipsychotic medications reveal a good deal of methodological limitations that make it difficult to reach any definitive conclusion about the impact of antipsychotic medications on quality of life. However, the weight of the evidence so far can only suggest a trend favouring the new antipsychotics in terms of their positive impact on quality of life. On the other hand it is clear that medications by themselves can not directly improve quality of life but certainly can improve the potential for patients to benefit from other important interventions such as rehabilitation and psychosocial support that can have direct impact on quality of life. A number of methodological and conceptual issues are proposed to improve the quality of quality of life studies. Finally, though quality of life by itself is an important outcome it is time for the field to look beyond quality of life measurements. In addition to being an outcome, quality of life improvement can be also construed as mediator of other important outcomes such as decreased relapse rate, re-hospitalization and medical resources utilization. Similarly, improvement in quality of life can enhance strategies for improving adherence to medications and other therapeutic regimens as well as better and longer tenure in the community