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The balance of benefits when taking medication

sławomir Murawiec, MD, PhD, Institute of Psychiatry and Neurology

You can read this text in 5 min.

The balance of benefits when taking medication

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Finding your way

When taking medication to treat schizophrenia (and all other medications) it is worth being aware of the issue of the benefit-cost balance of taking the medication.

Every drug is used because it cures or brings about an improvement in some disease. Antipsychotic drugs treat the symptoms of psychosis in schizophrenia and largely prevent relapse. Hypertension drugs normalise blood pressure and prevent its complications (such as heart attack, stroke). Insulin controls blood glucose levels and prevents complications of diabetes. And so it is with regard to many drugs. The element of benefit, of gain for the patient from taking the drug, must always be present.

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The second element (which drug manufacturers and doctors do not like at all and would prefer not to have) is the side effects of the drugs and the possible complications of taking them. This is the second element, the cost element of treatment (we sometimes talk about 'treatment tolerance'). Sometimes the administration of a drug requires tests at the start of treatment or repeated tests during treatment. Sometimes if you are taking the drug you have to follow certain dietary or other restrictions. Antipsychotic drugs can cause various side effects, depending on the specific drug. Drugs for high blood pressure also cause side effects. When treating diabetes, you have to control the levels and injections of the drug. This is simply the way it is.

Any medicinal substance can cause some side effects in some people or taking it involves some responsibilities or having to remember something, and sometimes a change in lifestyle (diet, activity). Every doctor would like this side of the cost to be as small or non-existent as possible. However, "miracle pills" have not yet been invented. Every doctor would prefer to be able to say - "this is a very effective medicine and has no side effects". In real life, however, this is not the case. Neither in a shop, nor in a pharmacy, nor in a laundry - you cannot get something for nothing.

Thus, the drugs used to treat schizophrenia and other illnesses are assessed by their manufacturers and doctors in terms of their benefit-cost balance. Of course, the benefits must many times outweigh the costs. That is to say, the drug gives very large benefits in most people at little cost.

This is evident in diabetes - the drug enables the patient to live at all, otherwise he would die. Nevertheless, he or she has to follow a diet, control blood glucose levels and inject insulin.

The same is true in schizophrenia and psychosis. Taking the drug enables many people to survive, who without the drug would have died (committed suicide, starved themselves, become victims of their own or others' aggression). There are scientific studies that confirm that far fewer people commit suicide if they are treated with antipsychotics for schizophrenia. In this sense too, taking medication allows very directly for survival. Taking the medication enables many people to have a good level of functioning, to interact with other people, to live with their family, to some people to work and study. It very clearly reduces the number of relapses and the need to go to hospital.