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Ask the Psychiatric Pharmacist #14

Written by Robert Elder, BS Pharm., and Joanne Hawley, Pharm.D.

Someone I really care about has mental illness but repeatedly stops taking his medication and his symptoms come back. Sometimes my friend has to be hospitalized. How can I help him?

One answer is to let the person with mental illness know that he can always count on your love and friendship, but their best chances of improvement will occur when they accept that medication is crucial to their recovery. Sometimes one can help persons struggling with mental illness (especially bipolar disorder or schizophrenia) decide for themselves which is worse – the short periods of time without the medication and side effects, followed by the inevitable resurgence of the illness (often times with worse symptoms than before).....or, the steadier, prolonged times of symptom-free living (or at least more manageable symptoms) while taking the medications, and coping with the side effects?  In a recent study, Hamann and colleagues have shown that higher rates of non-compliance with schizophrenia treatment were associated with re-hospitalizations between 6 and 18 months following a previous hospitalization.

Simply being hospitalized can help some of those suffering with mental illness be more compliant with their medications. To them, being hospitalized means “hitting rock bottom”, and they will be more motivated to change whatever they can to ensure a better recovery. Others may not be prepared, and will be more difficult to reach. For these people, consistent support and patience are important to maintain.

Another valuable action you can take is to tell your friend about NAMI. There may be a NAMI group in the community in which he lives. You could take him to a NAMI meeting. Show him how to get on the NAMI website and navigate to the different sections available ("Inform Yourself," "Find Support," and "Take Action"). Being an informed consumer will help him understand not only more about his illness but also about the important role medications can have in controlling his symptoms.

It's very important that your friend knows you will be there to help him when his symptoms are troublesome. Your support in helping him stay on his medications will benefit him greatly.

Hamann J, Cohen R, Leucht S et al. Shared Decision Making and Long-Term Outcome in Schizophrenia Treatment. J. Clin Psychiatry 2007;68:992-997.

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NAMI Wishes to thank the College of Psychiatric and Neurological Pharmacists for their participation in writing our medication fact sheets and for writing our "Ask the Psychiatric Pharmacist" questions and answers.

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