# 47 - Relapse or acute exacerbation of schizophreni

# Relapse or acute exacerbation of schizophrenia

Schizophrenia and related psychoses
CHAPTER 1
Relapse or acute exacerbation of schizophrenia
(adherence doubtful or known to be poor)
* Compliance aids (e.g. Medi-­Dose® system in the UK) are not a substitute for patient education. The ultimate 
aim should be to promote independent living, perhaps with patients filling their own compliance aid, having first 
been given support and training. Note that such compliance aids are of little use unless the patient is clearly 
motivated to adhere to prescribed treatment. Some medicines are not suitable for storage in compliance aids.
** Patients generally have positive views of depot medication.10,31
Investigate reasons for
poor adherence
Discuss with patient
Switch to antipsychotic medication with
a more favourable adverse-effect profile
Use LAI if patient agrees
Discuss with patient
Consider depot/LAI antipsychotic
medication**
Simplify drug regimen
Reduce any anticholinergic load
Consider ‘compliance aids’*
Consider depot/LAI**
Forgetful or
disorganised
Treatment algorithm
Lack of insight
or support
Poorly tolerated
treatment