Drug refusal in schizophrenia: causes and prescribing hints.

Many discharged patients diagnosed as schizophrenic do not continue to take their prescribed antipsychotic medication. Reasons for reluctance to take drugs include the development of extrapyramidal symptoms, most notably akathisia and akinesia; a poor doctor-patient relationship; or the patient's preference to continue his schizophrenic existence. To improve drug compliance, the physician should ask the patient about his impressions of side-effects and should let the patient help determine the optimal dosage.