Medication management of antipsychotic treatment in schizophrenia—A narrative review

Abstract

Background/Objective: The risk-benefit ratio of antipsychotics in schizophrenia depends primarily on their effect on brain chemistry. An important factor influencing the efficacy of prescribed drugs is medication management, which can be defined as an ongoing process to manage and monitor the recommended use of antipsychotics to facilitate their cost-effective, adherent, and acceptable use. Materials: We reviewed narratively relevant literature that examined the medication management of antipsychotics in schizophrenia based on a search of PubMed, Scopus, Web of Science, PsycARTICLES, and Cochrane in May 2020. We also included controlled interventional studies with a follow-up period of at least 2 years. Result: Based on the previous literature, there is no unified approach for optimal medication management, but multiple useful strategies are presented for individual patients, prescribers, and organizations. Conclusions: Systematic medication management may improve the risk-benefit balance of antipsychotics by achieving the lowest effective dose, minimizing adverse effects, and improving adherence. There is a need for well-designed naturalistic studies and clinical trials to optimize management in schizophrenia.