Impact of antipsychotic agents and their side effects on the quality of life in schizophrenia

Schizophrenia is the most chronic and disabling of mental illnesses and it imposes a disproportionately large economic burden on society. In addition to symptom reduction and cost-effectiveness, quality of life is becoming a critical outcome measure for the efficacy of antipsychotic agents in the treatment of schizophrenia patients. This review concentrates on the influences of antipsychotic agents and their side effects on quality of life of schizophrenia patients. Of the 182 papers elicited in a comprehensive Medline search from 1996-2002, we found only 21 significant papers (11.5%) reporting findings concerning the effect of antipsychotic agents on quality of life of schizophrenia patients. Very few studies directly examined the impact of side effects on quality of life ratings of schizophrenia patients. To date, there is no clear evidence that in the long-term, atypical antipsychotics are more effective or are better tolerated than typical antipsychotics. This review suggests that side effects of antipsychotic agents influence subjective quality of life of schizophrenia patients significantly less than clinical and psychosocial factors. The patient's subjective response to side effects of medication is more predictive of quality of life than the number of those effects. We discuss both patients' and clinicians' perceptions of side effects and quality of life, which should be considered in the evaluation of the efficacy of antipsychotic agents.