Background: This qualitative study explores the understanding and selfmanagement practice among patient with antipsychotic medications prescribed with ‘Pro Re Nata’ basis in Hospital Kajang, Malaysia. Method: A qualitative approach was employed using in-depth interview at psychiatric outpatient clinic in Hospital Kajang, Malaysia. Twelve patients were recruited via a purposive sampling method. An open-ended approach was used to obtain answers from patients. The data was collected through audio-recorded interviews and later was transcribed verbatim and were read repeatedly. Thematic analysis was used to identify themes from the transcripts. A constant comparison approach was used, whereby emerging themes and patterns are continually refined, compared and contrasted with the data as a whole. Organization and coding of data were done manually Results: A total of twelve patients were interviewed. Participant’s view that medication by PRN improve their health status and understand the medication is taken when needed basis. Barriers identified for understanding and self-management practice towards PRN medication include lack of knowledge towards the disease as well as drug and poor education level. Other barriers include individual culture and religion practice, influence of family member, and perceived lack of support from multidisciplinary teams in delivering genuine information regarding psychotropic medications. Conclusion: Managing patients with antipsychotic medications prescribed with PRN basis is still a challenge for Malaysian psychiatry doctors. Future intervention should focus on the identified barriers to improve the medication management and self-care of patient. Keywords: Medical problem, Prescriptions, Barriers, Extra pyramidal symptoms, Hospital Pharmacy, Pharmacists, Pro Re Nata (PRN)