Restart the previous medication. However, it is still important to understand why this medication was stopped or reduced.¹ If it was the physician's idea, is the diagnosis or other considerations that were in question now clarified? If it was the patient's idea, and it was not due to side effects, then what other reasons did the patient have for stopping or taking it irregularly? Was it related to concerns about the stigma of mental illness? Was it due to pregnancy or other reproductive concerns? Was it due to inability to pay for the medication or other practical barriers such as lack of transportation to a pharmacy? Psychotherapy and other psychoeducational counseling may be indicated to ensure that medication discontinuation does not occur again without it being a clear part of the treatment plan.
There are some patients with good insight into their need for medication who nevertheless stop it.¹ This type of health behavior is not limited to psychiatric patients. If no specific and remediable cause of the previous discontinuation can be discerned, and the patient cannot make a convincing case for why they will be more likely to continue the medication this time, it would be reasonable to discuss depot neuroleptic medication.
Recommendation #07
