![]() Specific treatments (such as an anticholinergic medication for managing antipsychotic-induced extrapyramidal effects) for a treatment-limiting adverse effect do not exist, are ineffective, or are contraindicated.A treatment-limiting adverse effect is unlikely to diminish at lower doses.The antipsychotic dose cannot be lowered because of unacceptable risk of clinical worsening.Switching may be especially indicated when: Under these circumstances, watchful waiting is typically not practicable, and a therapeutic antipsychotic switch may be indicated. When adverse effects are clearly attributable to the antipsychotic drug and outweigh clinical benefit or threaten adherence, they become treatment-limiting. Adverse effects are common during short- and long-term treatment with antipsychotics, some of which can be severe or persistent. Thus, before making the decision to switch, great care must be taken to ensure that treatment with the pre-switch antipsychotic was optimized in terms of adherence, treatment duration, and dose. A patient acutely relapses despite good medication adherence.Further dose increases or combination pharmacotherapy is contraindicated, is not likely to be effective, or is otherwise not feasible. ![]()
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