Real progress--the patient's perspective.

Experience from a UK national telephone helpline SANELINE (run by the mental health charity SANE), showed that availability and access to better medications and services are among the most important issues for patients with mental illness. SANELINE, therefore, conducted a survey of patients' satisfaction with antipsychotic medication between July 1998 and February 1999. A total of 202 completed questionnaires were available for analysis. A majority of patients (56%) were treated with conventional neuroleptics, 20% with new 'atypical' antipsychotics and 11% were on a combination of conventional and novel antipsychotics. Virtually all respondents (99%) reported suffering from at least one side-effect, of which 31% were perceived as 'severe' or 'very severe'. The most common side-effects reported were depression/low mood (90%), sedation (88%), difficulty in thinking/concentrating (78%), insomnia (68%), dry mouth (65%), muscle/joint stiffness (45%), sexual dysfunction (43%) and weight gain (39%). Notably, 73% of those who had experienced weight gain reported it to be 'quite or extremely distressing'. Depression was rated as 'quite or extremely distressing' by 67% of sufferers and insomnia was similarly rated by 66% of patients. Despite the methodological limitations of the survey, the results suggest there is a high level of patient dissatisfaction and distress related to the currently available medications, which may have unfavourable effects on compliance and treatment outcome.