The nurse is preparing for discharge of a client who has been hospitalized for paranoid schizophrenia. The client’s husband expresses concern over wher his wife will continue to take her daily prescribed medication. The nurse should inform him that:

Correct Answer: C. His wife can be given a long-acting medication that is administered every 1 to 4 weeks.

Long-acting psychotropic drugs can be administered by depot injection every 1 to 4 weeks. These agents are useful for noncompliant clients because the client receives the injection at the outpatient clinic. When schizophrenia is diagnosed, antipsychotic medication is most typically prescribed. This can be given as a pill, a patch, or an injection. There are long-term injections that have been developed which could eliminate the problems of a patient not regularly taking their medication (called “medication noncompliance”).

• Option A: A client has the right to refuse medication, but this issue isn’t the focus of discussion at this time. Someone with schizophrenia may not recognize that their behavior, hallucinations, or delusions are unusual or unfounded. This can cause a person to stop taking antipsychotic medication, stop participating in therapy, or both, which can result in a relapse into active phase psychosis.
• Option B: Medication should never be hidden in food or drink to trick the client into taking it; besides destroying the client’s trust, doing so would place the client at risk for overmedication or under medication because the amount administered is hard to determine. While antipsychotic medication is effective in treating the positive symptoms of schizophrenia, it does not address negative symptoms.8 In addition, these drugs can have unwanted side effects including weight gain, drowsiness, restlessness, nausea, vomiting, low blood pressure, dry mouth, and lowered white blood cell count.
• Option D: Assuming the client knows she must take the medication to avoid future hospitalizations would be unrealistic. Psychotherapy also plays an important role in the treatment of schizophrenia. Cognitive-behavioral therapy has been shown to help patients develop and retain social skills, alleviate comorbid anxiety and depression symptoms, cope with trauma in their past, improve relationships with family and friends, and support occupational recovery.