The need for long‐term neuroleptic treatment in schizophrenia

Abstract

The need for long-term neuroleptic treatment in nuclear schizophrenia depends on several factors, including the type of chronic schizophrenia, the phase of the disease, and the patient's total social situation. A neuroleptic drug withdrawal study demonstrated a need for further neuroleptic treatment for survival in the community even when the most symptom-free and socially best adapted chronic schizophrenics were considered. Prevention of relapse can apparently be achieved with lower neuroleptic doses than those necessary for optimal symptom suppression. Moreover, the patient's evaluation of his total social situation, including some quality-of-life aspects, must be considered as well as measures to avoid the patient becoming a burden on his family and friends. Neuroleptic treatment in adequate antipsychotic doses usually means a risk of early, immediate and possibly late side effects. In striking a balance between benefit and risk it seems preferable to keep the benefit strategy, which means that the main point will be to monitor neuroleptic and antiparkinsonian drugs with regard to optimal symptom suppression not accepting any possible late side effects as a guideline. This presentation will focus upon three questions concerning the long-term neuroleptic treatment of nuclear schizophrenia:1. which type of schizophrenia do we treat? 2. does the schizophrenic need long-term neuroleptic treatment? 3. if so, which is the best drug, and what is the ideal dose and most suitable form of administration for a. optimal symptom suppression, and b. prevention of relapse. SCHIZOPHRENIC SUBGROUPSThe diagnostic criteria for chronic schizophrenia have already been discussed by Wistedt (1980) and I agree with him on all points. The schizophrenic population varies however in several respects. These variable factors include the need for continuous hospital care and alternative support, the need for psychotropic drugs, psychotherapy and social training programmes, the quality-of-life and so on. I have not been able to

Antipsychotic Prescribing Pathways, Polypharmacy, and Clozapine Use in Treatment of Schizophrenia

“…Although antipsychotics are effective for the treatment of schizophrenia, many patients do not respond to the first antipsychotic prescribed (1)(2)(3). Patients without a response on a second antipsychotic trial are typically considered treatment resistant (4)(5)(6)(7)(8)(9)(10).…”

A review on schizophrenia and relapse—a quest for user‐friendly psychopharmacotherapy

“…Another study found relapse rate of 41% among those who continued quetiapine versus 79% who discontinued the medication at 1 year (Hui et al, 2013b). A number of studies and reviews converge to underscore the importance of poor adherence (or formerly compliance) in schizophrenia although they may differ to point out other risk factors (Dencker, 1981;Hogarty, 1993;Kissling, 1994;Gaebel, 1997;Kane, 1997;Mwaba and Molamu, 1998;Csernansky and Schuchart, 2002;Bradford et al, 2003;Barnes, 2004;Heller et al, 2006;Schooler, 2006;Kazadi et al, 2008;Kim et al, 2008;Ascher-Svanum et al, 2010;Xiang et al, 2011;Schennach et al, 2012;Hui et al, 2013a). The study by Caseiro et al (2012) for instance identified non-adherence as the sole offender with a hazard ratio of 4.8 for relapse.…”

Psychiatric Polyclinic: A Cross Sectional Study in the Context of Schizophrenia Treatment

“…Diğer olarak sınıflandırılan gurupta ise 5 IQ sorunu, 1 cinsel işlev bozukluğu, 2 kişilik bozukluğu, 3 davranım bozukluğu, 7 çevresel stresör (eksen-4), 1 kekeleme ve 8 vitamin B-12 eksikliği saptanmıştır. (Tablo A-2) Antipsikotik tedavi, etkin şizofreni tedavisinin esas kısmını oluşturmaktadır [10][11][12]. Tipik antipsikotikler 1950'lerden itibaren kullanılmaktadır.…”