Treatment of schizophrenia involves the judicious use of multiple treatment modalities, of which pharmacology is among the most important. Second-generation atypical antipsychotics provide substantial advantages over first-generation generation conventional agents. To maximize the benefits of atypical antipsychotics, the dose of medication should be carefully adjusted to achieve as complete a remission of psychotic symptoms as possible, without accompanying EPS. The major advantage of atypicals is lost if EPS occur; the occurrence of EPS should be considered an adequate justification for a downward adjustment in dose or change in medication. Since each pharmacological treatment regimen has its own unique range of likely benefits and side effects and these, in turn, are of very different relevance and importance to each individual patient, treatment obviously must be individualized. Optimal pharmacotherapy of schizophrenia requires a careful balance between the efficacy benefits and the side effect costs customized for each individual patient. Nonpharmacological treatments and mental health system issues (continuity of care, reimbursement, access to effective treatments, etc.) also warrant attention as one strives to improve the quality of life of individuals afflicted with schizophrenia.
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