Schizophrenia is a very common condition affecting almost 1% of the population (McGrath et al, 2008). Because of the severity as well as high prevalence, treatments which improve outcome may have a considerable effect on the healthcare budget.

A review of the treatment of schizophrenia and related disorders asked the question whether or not we should be reviewing the advice that all such patients should be advised to take antipsychotic medication (Morrison et al, 2012a). The authors argue that the evidence for the effectiveness of antipsychotic drugs is less strong than previously thought and that the risk of adverse outcome and side-effects has been underestimated. The suggestion is made that patients should work collaboratively with a therapist to make an informed choice about whether or not they wish to take these drugs. Patient and therapist collaboration is a hallmark of CBT and the suggestion is that CBT and/or family therapy can be offered in lieu of dopamine-blocking drugs. However, the number of studies which examine the use of CBT without the use of psychopharmacological agents is very few (e.g. Morrison et al, 2012b). Most evidence to suggest that patients may get better without drugs relies on examination of people with poor adherence to medication. Whereas this information may be generalisable to the whole population diagnosed with schizophrenia, it may also be that some patients stop the medication because they only have mild symptoms.