Non-extrapyramidal side-effects in neuroleptic longterm treatment: an analysis of 99 patients

Compliance is the degree of adherence to medical advice. Therapeutic success, especially in long-term therapy, largely depends on the patient's compliance. Advances in psychopharmacology have led to the production of medications with substantial efficacy in the treatment of schizophrenia. The tolerability profile of these atypical antipsychotic drugs shows a lower incidence of extrapyramidal motor side effects. However, other, perhaps more trivial, side effects impair their good tolerability and may severely reduce compliance. We assessed the acceptance of these side effects in 99 patients under neuroleptic long term treatment. Difficulties to concentrate, weight gain, dizziness, vision impairment, and headache were found to be the subjectively most distressing side effects. Female patients may be at particular risk of discontinuing medication due to side effects (especially weight gain). Our results suggest that noncompliance as a clinical problem should lead to an individualized treatment, which is best developed in the context of an ongoing physician-patient relationship. Furthermore the assessment of other neuroleptic side effects besides motor disturbances seems to be of outstanding importance.