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Brief Intermittent Neuroleptic Prophylaxis for Selected Schizophrenic Out-patients

Published online by Cambridge University Press:  02 January 2018

H. A. McClelland
Affiliation:
St Nicholas Hospital, Gosforth, Newcastle-upon-Tyne NE3 3XT
G. Harrison
Affiliation:
Academic Department of Psychiatry, University Hospital, Nottingham NG7 2UH
S. D. Soni
Affiliation:
Salford Health Authority, Hope Hospital, Eccles Old Road, Salford M6 8HD
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Abstract

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“A study was conducted to investigate a novel approach to the prophylaxis of schizophrenic relapse. The treatment strategy comprised brief intermittent courses of neuroleptic agents begun as soon as non-psychotic symptoms believed to be early signs of relapse appeared. Fifty four stable, remitted outpatients meeting the American Psychiatric Association's DSM–III criteria for schizophrenia were randomised double blind to receive brief intermittent treatment with either active or placebo depot neuroleptic injections. Only three patients given placebo injections and two controls were admitted to hospital during one year of follow up. Eight (30%) of the patients given placebo injections and only 2 (7%) of the controls, however, had a recurrence of schizophrenic symptoms. Patients given placebo injections experienced fewer extrapyramidal side effects and showed a trend towards a reduction in tardive dyskinesia. Dysphoric and neurotic symptoms were identified before eight out of 11 relapses, and these symptoms were more frequent in patients given placebo depot injections. These results suggest a viable but not necessarily better alternative to continuous oral or depot treatment for less ill, chronic, stabilised schizophrenics based on the early treatment of putative prodromal symptoms of relapse.”

Type
The Current Literature
Copyright
Copyright © Royal College of Psychiatrists, 1989 

References

Carpenter, W. T. & Heinrichs, D. W. (1983) Early intervention, time-limited, targeted pharmacotherapy of schizophrenia. Schizophrenia Bulletin, 9, 533542.CrossRefGoogle ScholarPubMed
Carpenter, W. T., Heinrichs, D. W., Hanlon, T. E. (1987) A comparative trial of pharmacological strategies in schizophrenia. American Journal of Psychiatry, 144, 14661470.Google ScholarPubMed
Chiles, J. A., Sterchi, D., Hyde, T., et al (1989) Intermittent medication for schizophrenic outpatients: who is eligible? Schizophrenia Bulletin, 15, 117120.CrossRefGoogle ScholarPubMed
Ciompi, L. (1980) Catamnestic long-term study on the course of life and aging of schizophrenics. Schizophrenia Bulletin, 6, 606618.CrossRefGoogle ScholarPubMed
Docherty, J. P., Van Kammen, D. P., Siris, S. G., et al (1978) Stages of onset of schizophrenic psychosis. American Journal of Psychiatry, 135, 420426.Google ScholarPubMed
Herz, I. M. & Melville, C. (1980) Relapse in schizophrenia. American Journal of Psychiatry, 137, 801805.Google ScholarPubMed
Herz, I. M., Szymanski, H. V. & Simon, J. C. (1982) Intermittent medication for stable schizophrenic outpatients: an alternative to maintenance medication. American Journal of Psychiatry, 139, 918922.Google ScholarPubMed
Hogarty, G. E. (1984) Aftercare treatment of schizophrenia. In Seminar on Schizophrenia (ed. S. R. Hirsch), pp. 3842. London: Update.Google Scholar
Hogarty, G. E., McEvoy, J. P., Munetz, M., et al (1988) Dose of fluphenazine, familial expressed emotion, and outcome in schizophrenia. Archives of General Psychiatry, 45, 797805.CrossRefGoogle ScholarPubMed
Johnson, D. A. W., Ludlow, J. M., Street, K., et al (1987) Double-blind comparison of half-dose and standard-dose flupenthixol decanoate in the maintenance treatment of stabilized out-patients with schizophrenia. British Journal of Psychiatry, 151, 634638.CrossRefGoogle ScholarPubMed
Jolley, A. G., Hirsch, S. R. & Manchanda, R. (1989) Trial of brief intermittent neuroleptic prophylaxis for selected schizophrenic out-patients: clinical outcome at one year. British Medical Journal, 298, 985990.CrossRefGoogle ScholarPubMed
Marder, S. R., Van Putten, T., Mintz, J., (1987) Low- and conventional-dose maintenance therapy with fluphenazine decanoate. Archives of General Psychiatry, 44, 518521.CrossRefGoogle ScholarPubMed
Van Putten, T. (1974) Why do schizophrenic patients refuse to take their drugs? Archives of General Psychiatry, 31, 6772.CrossRefGoogle ScholarPubMed
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