Reply To: Medication Adherence


Katelyn, your Sex Love and Relationships group is such a wonderful initiative. Not only are you opening conversations that are often stigmatized/minimized but you are also helping people realize that they are not alone in their experience. Hats off you you and your colleague!

I think what you all have written above captures excellent ways to support clients who have stopped taking medication or are considering stopping taking medication. One thing I would add is that I think monitoring for positive effects, negative side effects and persistent symptoms despite taking meds is important, I think it can be equally important if a client is choosing not to take meds. the same strategies can hold – checking in regarding improvements, side effects or persistent symptoms. Comparting the data before going off meds to the data after going off meds can be very powerful in highlighting the impact of medication (both good and bad) and helping a client make a decision (hopefully this is done with their prescribing doc) as to how they want to proceed.

While my experience with this wasn’t psychosis related, I had a youth who was taking risperidone. The client was hesitant but agreed and so we decided to conduct an ‘experiment’ wherein we tracked the clients experience of all of the potential benefits and the potential side effects of the medication that the psychiatrist listed. Ultimately, after 5 or 6 months the client decided that they wanted to stop medication, against the recommendation of their psychiatrist, due to weight gain and the fact they didn’t think they needed it anymore. I respected my clients decision and we continued with our weekly appts in which we continued to capture data like we had done before. I forget the exact numbers now but as the client went off risperidone we noticed an increase in arguments with parents, damage to property at home, and lower mood (likely due to the discord). When the client saw the numbers they realized that the risperidone was likely correlated with symptom improvement and so decided to go back on. I’m not sure without the quantifiable evidence that the risperidone was working that the client would have decided to go back on the meds.