Long-Term Considerations After Switching Antipsychotics
Peter J. Weiden, M.D.; Ralph Aquila, M.D.;
Marianne Emanuel, R.N.; and Annette Zygmunt, M.S.
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The so-called “atypical” antipsychotics are rapidly becoming the de facto standard pharmacologic
treatment of schizophrenia. This article reviews some common psychopharmacologic and psychological
issues that may arise after an outpatient with schizophrenia is switched to one of the newer antipsychotics.
Important issues to consider in the first few months after switching include assessment of
response to the new medication, dealing with subsequent psychological reactions, and management of
an unsatisfactory response. Once the response is established, there are other pharmacologic and psychological
issues that arise during the next year or two. Pharmacologic issues that emerge later on
include the role of long-term combination antipsychotics, management of new side effects, and deciding
whether and when to switch again. Some of the long-term psychological issues include changes in
self-image that arise from being less visibly ill, sexuality and intimacy concerns, and recovery issues.
J Clin Psychiatry 1998;59(suppl 19):36–49
© Copyright 1998 Physicians Postgraduate Press, Inc.
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