OBJECTIVES: Considering the patients point of view in treatment decision making is crucial for a successful therapy. In contrast to somatic diseases in schizophrenia there are only few examples where the patients attitude and point of view was systematically recorded. Objective of the study was to collect the attitude of schizophrenic patients towards generic substitution of atypical antipsychotics. METHODS: In the quantitative survey schizophrenic patients, capable to give one´s consent, aged 18 - 60 years were interviewed on the basis of a structured questionnaire. All participants received a second generation antipsychotic for at least one year. Getting in contact with the patients was facilitated via practice-based psychiatrists who secured the recruitment of the appropriate patients in line with the screening criteria.    RESULTS: The survey was conducted in November/December 2007. 104 patients (Æ 41.2 ± 11.1 yrs.; Æ treatment duration 3.5±3.2 yrs.). According to the patients' information drug treatment was changed 1.7 times on average during the last 5 years (range 1-14). In case of a generic substitution initiated by the attending physician 69% of the patients expressed a willingness to take the medication further on.  The acceptance of a treatment switch was reduced if the switch was not justified by a lack of efficacy/tolerability (28%). Especially the regular switch of drugs with the same agent in the pharmacy would be met with a refusal as voiced by 76% of the patients. CONCLUSIONS: The study shows that the conduction of a quantitative survey with schizophrenic patients is feasible and differentiated statements regarding patients' attitudes towards pharmacotherapy can be generated. The results emphasize the importance of an extensive education of the patients prior to a generic substitution in order to support therapy adherence, which is fragile per se. Physicians are expected to fulfill this educational task.