For those clients who initially refuse drug management, the case manager continues to provide support and education to the patient and family. Antipsychotic therapy is the cornerstone of treatment of psychosis.
All antipsychotic drugs are more or less equally efficacious.
However, special considerations are necessary when treating individuals with a first episode of psychosis, most of whom are young, and have never been exposed to these powerful agents. In order to avoid immediate discomfort associated with motor side effects and dysphoria associated with typical antipsychotic drugs, low doses of novel antipsychotic drugs are advised to be the first choice. If the patient is started on an antipsychotic medication on an outpatient basis and if this is the very first dose of an antipsychotic, the case manager keeps in close contact with the client. The case manager will then follow-up with a visit and telephone calls for the next few days. In the early stages of treatment, the majority of the case manager's time is spent helping the client and family adjust to the issues around antipsychotic medication including symptom relief, side effects, compliance, etc.