Subjective effects of neuroleptics predict compliance

  • D. Naber
  • A. Walther
  • T. Kircher
  • D. Hayek
  • R. Holzbach


The low compliance of long-term neuroleptic treatment might be explained not only by extrapyramidal motor side effects (EPMS) but also by other subjective effects, hardly measurable by usual clinical rating scales. Therefore, a self-rating scale to measure subjective well-being on neuroleptics (SWN) was developed; first analyses indicate good practicability, reliability, validity and sensitivity. As the acute psychosis subsides, schizophrenic patients are able to fill out the questionnaire in 15–20 minutes.

Data, obtained from 216 remitted patients, showed that SWN correlates with psychiatrist’s ratings (PANSS), self-ratings of mood states (POMS, SDS, BfS) and EPMS; but variables explained only 19–47% of SWN variance. A repeated application after 3 months in 53 patients did not show any altered SWN in those with constant neuroleptic medication. Marked alterations were noted if dosage or drug was changed. SWN in 28 patients, treated with clozapine because of therapy resistance or major side-effects, was despite of the negative selection, significantly better (t=2.34, p =.02) than in 38 patients under classical neuroleptics. Moreover, already at discharge, patients who 4–6 months later were non-compliant (n=14), differed significantly (t=2.31, p =.02) in SWN, but not in BPRS or PANSS from those who remained compliant (n=34).

These data agree with clinical experience and show that SWN is a useful tool to investigate a hitherto neglected psychopathological dimension. The early detection of major subjective effects of neuroleptics might be helpful in identifying patients at risk of noncompliance. In these patients, strategies such as depot-injection, reduction of dosage or change of medication should be considered.


Negative Symptom Schizophrenic Patient Subjective Effect Neuroleptic Drug Neuroleptic Treatment 
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Copyright information

© Springer-Verlag Wien 1994

Authors and Affiliations

  • D. Naber
    • 1
    • 2
  • A. Walther
    • 1
  • T. Kircher
    • 1
  • D. Hayek
    • 1
  • R. Holzbach
    • 1
  1. 1.Department of PsychiatryUniversity of MunichGermany
  2. 2.Department of PsychiatryUniversity of MunichMunichGermany

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