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Published Online:https://doi.org/10.1176/ps.41.5.541

Treatment of poorly functioning schizophrenic patients with antidepressant medication may lead to a relatively rapid increase in their level of activity, autonomy, and assertiveness. Caregivers who had been accustomed to the patients' more blunted affect and docile behavior may perceive this change as an increase in hostility. Patients who do not know how to express anger and other strongfeelings appropriately may also find changes in their level of assertiveness to be stressful. The authors illustrate these problems with case examples and suggest that psychoeducation, regular contact with the treatment team, and training in communication can help both patients and caregivers adjust to the patient's improved condition.

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