The importance of early treatment of schizophrenia.

It is extremely important to treat schizophrenia as soon as possible after the onset. With delay in effective treatment, patients may be at increased risk for brain volume loss with adverse implications for long-term treatment outcomes. Providers should not try to "instruct" patients with schizophrenia, who often have impaired verbal learning abilities, about the necessity of adhering to their medication regimen, but instead should try to demonstrate that the treatment can effectively improve their lives. To this end, it is crucial to find a medication at a dose that relieves psychotic and affective psychopathology as quickly as possible. To optimize treatment adherence, it seems more practical for providers to help patients with schizophrenia feel subjectively better and recognize improvement than to impress them with the logic of the argument for taking medications. In treating schizophrenia, physicians also should be involved and accessible to patients and caregivers. Providers should treat their patients with respect, express their viewpoint succinctly and consistently, and make clear that the betterment of the patient is their goal.