1.Will the disease worsen if the wrong drug is used? Should I stop or reduce the medication immediately if it is not effective? Will the condition worsen if the wrong medication is used? In the case of schizophrenia treatment, whether you choose a first- or second-generation antipsychotic drug, it is effective for the disease. Of course, each drug has its own characteristics, and some are suitable for acute treatment, while others may be more suitable for maintenance treatment. There is a possibility that the use of antipsychotic drugs is mistakenly used with other drugs, such as the use of risperidone drugs and the use of carbamazepine at the same time, which affects the blood concentration of antipsychotic drugs due to the interaction between drugs, resulting in a significant decrease in the blood concentration of risperidone, which can lead to the aggravation of psychiatric symptoms in clinical practice. For the question of whether to immediately stop or reduce the drug without efficacy, several aspects should be considered: (1) the principle of using antipsychotic drugs is full amount and full course of treatment, if the efficacy is still not good according to the treatment principle, one option is to consider the combination of two drugs, and the combination of drugs with different pharmacological effects is more appropriate, and it is still best to use a single drug after achieving the expected therapeutic goal; another option is to switch to another Another option is to switch to another chemically structured atypical drug or a typical drug, when the principle of drug reduction is to slowly reduce the original drug and slowly add the new drug, which can reduce withdrawal reactions and symptom rekindling, but may also increase the adverse reactions caused by the combination of two drugs. (2) Just as the dose should be gradually increased at the beginning of the drug, the drug should also be gradually reduced when it is discontinued, but it should also be considered that if the dose of the drug itself is small, it can be directly discontinued; however, if the dose is large, it is best not to stop the drug suddenly, especially drugs like clozapine, should not be stopped suddenly to prevent the emergence of withdrawal syndrome. There is a situation can be immediately discontinued, that is, there are serious adverse reactions such as serious extrapyramidal adverse reactions, serious malignant syndrome and other life-threatening, you can consider immediately stop the drug and take appropriate measures. 2.After taking the drug, are the symptoms such as tremor of the limbs, dull eyes, and slow movement side effects of the drug or aggravation of the disease? Is it necessary to stop or change the medication if side effects occur? Let’s look at the conditions under which the patient may experience tremors, dullness of gaze, and slowness of movement. (1) Patients may experience these symptoms when they have adverse reactions. Antipsychotic reactions can lead to extrapyramidal adverse reactions and drowsiness reactions. Extrapyramidal adverse reactions are often manifested as tremor of the limbs, increased muscle tone, and slowed movement, while drowsiness reactions can also manifest as slowed movement and dull gaze. (2) Psychiatric symptoms are complex and varied, and the above symptoms may also occur. Patients with schizophrenia may have anxiety and tremors in the limbs during anxiety attacks; dull gaze and slow movement in submuscular rigidity; and dull gaze and slow movement in depression. Therefore, is it a side effect of the drug or an aggravation of the disease? It depends on the patient’s symptom characteristics, drug characteristics and the relationship between symptoms and the time of taking the drug. In case of drug side effects, observation and timely management are required, but discontinuation or change of medication may not be necessary. Extrapyramidal reactions can be controlled by combining anticholinergic drugs such as benzhexol, while drowsiness reactions tend to appear in the first 2 weeks of taking the drug, after which they will be gradually reduced and tolerated. We can also reduce the number of drugs with side effects and combine them with another antipsychotic. If the side effects are really intolerable, you can consider stopping or changing the medication. 3.What do I need to pay attention to when stopping and changing medication? How to make a safe transition? Antipsychotic treatment must adhere to the principle of adequate dose and duration of treatment. It is undesirable to abandon treatment or change medication frequently without adequate treatment (insufficient dose and short duration of treatment). Only after a sufficient dose and a sufficient course of treatment (4-8 weeks) is ineffective, a change to another antipsychotic can be considered. After long-term use of an antipsychotic drug, the body deals with the adaptation state of the drug, and sudden discontinuation of the drug may affect the internal homeostasis of the body, causing physical maladjustment and even recurrence of psychiatric symptoms. Therefore, the principle of dose-by-dose-decrease should be considered when discontinuing or changing medication to reduce discontinuation reactions, and attention should be paid to observe whether there are discontinuation reactions and recurrence of psychiatric symptoms during the process of discontinuation or change of medication. How to make a safe transition when changing medication due to treatment needs? Commonly used medication change methods are: (1) partial overlapping medication change, decreasing the first medication and increasing the other medication, this medication change method is safer and more reliable, and is also the most commonly used medication change method in clinical practice; (2) complete overlapping medication change, when the new medication is added to reach the therapeutic dose, then slowly decreasing the previous medication, this method can ensure the maximum control of psychiatric symptoms, and is suitable for patients with persistent psychiatric symptoms. However, there is a period of overlap between the two drugs to reach the therapeutic dose, and the risk of side effects should also be considered; (3) interval drug change, first stop the first drug, and then use the second drug at an interval, the change method minimizes the side effects, while avoiding the adverse effects of the interaction between the two drugs, but it is easy to lead to recurrence of psychiatric symptoms, so it is often used in patients with mild conditions, and the drug changed will have adverse effects with the original drug (4) no interval change, immediately stop using the first drug and switch to another drug, this method is applicable to the first drug for a short period of time, withdrawal reaction is small. 4.Do children with schizophrenia have to take medication for life? Schizophrenia can be divided into acute treatment, recovery treatment (consolidation treatment) and maintenance treatment according to the course of the disease. Acute treatment: (1) Patients in the acute phase have distinct clinical symptoms, with positive symptoms, agitated impulsivity, and impaired cognitive function as the main manifestations, so it is appropriate to take active and intensive medication to try to relieve symptoms and prevent instability of the disease; (2) try to expand the proportion of patients who are basically cured; (3) medication is recommended for the treatment program, with a course of treatment of at least 4-6 weeks; (4) choose a treatment site according to the condition, family care and medical conditions. (4) choose the treatment site according to the condition, family care and medical conditions, including inpatient, outpatient, community and home bed treatment; when the patient has obvious danger to social security and serious suicidal and self-injurious behavior, through the guardian’s consent need to emergency admission to active treatment; (5) family education and psychological treatment for patients. Recovery treatment (consolidation treatment): (1) The main treatment is still medication; continue to consolidate treatment with the original effective dose; the course of treatment should be at least 3-6 months. (2) Treatment place can continue inpatient combined with trial discharge to adapt to community life; or regular follow-up treatment in outpatient discharge; or community treatment. (3) In conjunction with family education and psychotherapy for patients. Maintenance treatment: (1) according to the individual and the medication used, determine whether to reduce the dose and grasp the dose needed to prevent relapse; (2) stable efficacy, no special adverse reactions, as far as possible, no change of medication; (3) the course of treatment depends on the individual patient, generally not less than 2-5 years, the treatment site mainly in outpatient follow-up and community follow-up treatment; (4) strengthen the psychological treatment of patients and their families. In summary, the treatment of childhood schizophrenia should be divided into courses, which vary according to the duration of the disease, the number of episodes, and the residual psychiatric symptoms. Overall, the medication period cannot be shorter than 2 years for first-episode, acute onset, and short duration, and patients with recurrent episodes often require long-term maintenance treatment. Patients who need long-term maintenance treatment, how long it takes, should weigh the pros and cons of taking and stopping medication, and decide together with parents and patients in consultation. 5. Is there a long-term solution for children who do not want to take medication? For children who do not want to take medication, typical and atypical antipsychotic drugs such as haloperidol injections can be used at the beginning of treatment. In addition, long-acting injections or long-acting drugs can also be used for treatment, such as pentoxifylline and Sinestra, etc. However, long-term injections may cause extrapyramidal side effects, so physicians and parents need to weigh the pros and cons and discuss together to determine the long-acting approach.