Antipsychotic Medication Nonadherence: Risk Factors and Remedies

Understanding determinants of antipsychotic medication adherence is critical as nonadherence plays a significant role in psychotic relapse and each relapse contributes to accrued social toxicity and disability. “Insight” or lack thereof and a negative medication attitude are critical variables that have repeatedly been shown to be risk factors for nonadherence.

Understanding determinants of antipsychotic medication adherence is critical as nonadherence plays a significant role in psychotic relapse and each relapse contributes to accrued social toxicity and disability. “Insight” or lack thereof and a negative medication attitude are critical variables that have repeatedly been shown to be risk factors for nonadherence. We examine how those risk factors can lead to nonadherence and describe evidence-based interventions to improve nonadherence. We also discuss newer approaches adapted from other branches of medicine that have shown some promise in increasing adherence to antipsychotics, specifically directly-observed-therapy (DOT) and providing financial incentives. Adherence-improving interventions need to be deployed in a stepped-up manner of increasing intensity and tailored to the specific etiologies of nonadherence.