Cognitive-behavioral therapy in psychotic patients requires several cognitive strategies that may be affected by cognitive dullness, sedation and drowsiness that may appear as side effects to the medication. In addition, cognitive symptoms per se are a symptomatic conglomerate of great importance in schizophrenia and may also affect the course of therapy. The adherence to the treatment is largely derived from the side effects of the drugs, there is a lack of adherence to the pharmacological treatment. This aspect should be addressed in therapy sessions. It is important to make the patient understand the need for medical treatment, educate him about its side effects (explain that many of them can be controlled by adjusting the doses or with a coadjuvant medication). Pharmacological treatment often becomes the subject of discussion during therapy, the aim is twofold:

• Normalize side effects as much as possible and try to minimize their negative effects on psychological treatment.
• Explain to the patient the need to continue medical treatment despite experiencing an improvement for at least one year to prevent relapse.

The family plays a very important role in monitoring medication and ensuring adherence, as well as in identifying prodromal symptoms and warnings of possible relapse.

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