Approximately 40% of patients with schizophrenia either do not respond to the prescribed antipsychotic drug or cannot tolerate it because of side effects, resulting in poor disease control and negative health and economic outcomes. Identifying the root cause of such complicated courses of treatment is a critical step in the treatment of these patients. Although measurement of antipsychotic plasma levels can be used to discern potential root causes, this tool is not routinely used in the United States. The authors of this column discuss the potential effects on patient outcomes and on the value of care from greater use of this diagnostic tool, especially under emerging payment models and delivery system reform efforts.
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