Should I try a new antipsychotic if mine stops working at 38?

Question

Hello doctor,

I am a 38-year-old male with schizophrenia, and the medication I have been stable on for years suddenly feels like it is no longer helping as much as before. I am experiencing more breakthrough symptoms, and honestly, it is frightening because achieving stability took a long time.

Part of me worries that switching medications could make things worse, but remaining stuck with increasing symptoms is not ideal either.

For people with schizophrenia, how do doctors determine when it is time to try a different antipsychotic medication instead of simply adjusting the dosage of the current one?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Relapses or exacerbations of symptoms are common in schizophrenia (a serious mental health condition that affects how people think, feel, and behave), even with regular adherence to treatment.

However, consistent use of prescribed medication significantly reduces the risk of relapse, and the severity of symptoms during a relapse is usually much lower than it would be without treatment.

Yes, there is always a possibility of relapse when switching from one antipsychotic medication to another. If a person with schizophrenia shows no improvement or only partial improvement despite receiving an optimal dose of the chosen antipsychotic for three to four weeks, with more than 80 percent adherence to the medication, they may be considered a poor responder.

In such cases, switching to another antipsychotic medication may be considered.

However, it is important to note that a reduction of more than 25 percent in symptoms is generally regarded as a good treatment response in schizophrenia.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.