Valid grounds for the switch of original antipsychotics with generics.

Psychiatr Danub

University Psychiatric Clinic Rijeka, Clinical Hospital Centre Rijeka, Kresimirova 42, 51000 Rijeka, Croatia.

Published: March 2010

Patients' non-compliance in treatments, such as irregular taking of medication, represents an enormous problem with psychiatric patients in general. This difficulty occurs especially in patients suffering from chronic mental illnesses such as schizophrenia. There are not any significant differences in the efficacy of reducing the positive symptoms in schizophrenia between the conventional and the atypical antipsychotics. However, the effects which are manifested in negative schizophrenia symptoms or in the patients' cognitive functioning, favour the atypical antipsychotics. When it comes to adding the subjective well-being of the patients and their improvement of the quality of life, then, the advantages of atypical antipsychotics are unquestionable. New trends in medicine are increasingly impinge on the pharmacoeconomy, which aims at reducing treatment cost. This trend is getting progressively stronger in the world and as such, it certainly will not bypass Croatia. Pharmacists and General Practice doctors (GP) are permitted, by the law, to replace the original medicament prescribed by a specialist doctor, with a cheaper one from the same generic group of medicaments, with a purpose of cutting down the treatment costs. Is there always a valid justification for such practice, and should it become a rule for all the patients out there? This is a case report of a patient who suffers from paranoid schizophrenia. He has been on a treatment with atypical antipsychotics and has kept in a good and stable remission for the past seven years. His therapy consisted of olanzapine in a dose of 15 mg in the evening, throughout the whole period of his 7-year remission. A month ago, his GP doctor self- initially prescribed a generic olanzapine. The impact of this decision on to the mental state of the patient as well as his trust in the treatment itself is described in this report.

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