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This study also reported a number of patient-related factors that may affect these dosing recommendations .
Nevertheless, consensus strategies for switching between different antipsychotic treatments are lacking.
Discontinuation and frequent switching of antipsychotic medication are common in the treatment of patients with schizophrenia.
Reasons for discontinuing or switching antipsychotic medications can include lack of efficacy  involved 1,492 patients randomized to receive either the oral first-generation antipsychotic (FGA) perphenazine or one of a number of oral second-generation antipsychotics (SGAs) (olanzapine, quetiapine, risperidone, or ziprasidone) for up to 18 months.
The clinical experience is reflected within this manuscript and is supported by a detailed discussion of pertinent literature, as reviewed by the authors, including articles describing antipsychotic switching techniques and strategies, and findings from paliperidone ER clinical trials.
Switching antipsychotic treatments can deliver potential benefits.
In addition, a survey conducted in Europe, the Middle East, and Africa suggested that 34% of psychiatrists would consider altering their patient's pharmacotherapy if they believed the patient to have impaired social functioning, while 27% of respondents indicated that switching antipsychotics would be their preferred pharmacological strategy in order to address deficits in social functioning in patients with schizophrenia .
Switching of antipsychotic medication due to lack of efficacy, tolerability issues, and partial/non-adherence is common.This study highlighted that 74% of patients discontinued the antipsychotic medication they were assigned at randomization before the end of the 18-month period.The most common reasons for discontinuation were lack of efficacy and intolerable side effects.These may include improved efficacy, tolerability, adherence, functioning, and quality of life, while reducing hospitalization rates .Consideration of the pharmacokinetic (PK) and pharmacodynamic (PD) profiles of antipsychotic medications are crucial for successful titration, dosing, and switching.