Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-18T06:21:14.715Z Has data issue: false hasContentIssue false
  • English
  • Français

Relapse in Chronic Schizophrenics following Abrupt Withdrawal of Tranquilizing Medication

Published online by Cambridge University Press:  29 January 2018

Robert F. Prien ,
Jonathan O. Cole  and
Naomi F. Belkin§
Robert F. Prien
Affiliation:
Central NP Research Laboratory, VA Hospital, Perry Point, Maryland 21902
Jonathan O. Cole
Affiliation:
Boston State Hospital, 591 Morton Street, Boston, Massachusetts, 02124
Naomi F. Belkin§
Affiliation:
The Biometric Laboratory, The George Washington University, 1145 19th Street, N.W. Room 618, Washington, D.C., 20036
Get access Rights & Permissions [Opens in a new window]

Extract

Physicians are often faced with the problem of determining whether long-stay schizophrenics require continuous treatment with tranquillizers. Prolonged ingestion of ataractics has both physical and economic disadvantages. Recent reports on oculo-cutaneous changes (3, 13, 20, 27, 28), persistent dyskinesia (6, 18) and sudden deaths (16, 25) have focused attention on the potential dangers of prolonged use of tranquillizing medication. On the other hand, discontinuation of medication may lead to recurrence of acute psychotic behaviour. The literature on drug withdrawal provides no solution to the dilemma. The results from drug discontinuation studies are complex and contradictory. Some investigators report extremely high relapse rates while others report little deterioration even when drugs are withdrawn for long periods of time. A brief review of the literature will give some indication of the contradictory nature of results.

Type
Pharmacotherapy
Information
The British Journal of Psychiatry , Volume 115 , Issue 523 , June 1969 , pp. 679 - 686
Copyright
Copyright © Royal College of Psychiatrists, 1969 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Barrett, W. W., Ellsworth, R. B., Clark, L. D., and Enniss, J. (1957). “Study of the differential behavioral effects of reserpine, chlorpromazine and a combination of these drugs in chronic schizophrenics.” Dis. new. Syst., 18, 209–215.Google Scholar
2. Blackburn, H., and Allen, J. (1961). “Behavioral effects of interrupting and resuming tranquilizing medication among schizophrenics.” J. nerv. ment. Dis., 133, 303–307.Google Scholar
3. Bock, R., and Swain, J. (1962). “Ophthalmological findings in patients on long-term chlorpromazine therapy.” Amer. J. Ophthal., 56, 808–810.Google Scholar
4. Brooks, G. W. (1959). “Withdrawal from neuroleptic drugs.” Amer. J. Psychiat., 115, 931–932.Google Scholar
5. Caffey, E. M., Diamond, L. S., Frank, T. V., Grasberger, J. G., Herman, L., Klett, C. J., and Rothstein, G. (1964). “Discontinuation or reduction of chemotherapy in chronic schizophrenics.” J. chron. Dis., 17, 347–358.Google Scholar
6. Crane, G., and Paulson, G. (1967). “Involuntary movements in a sample of chronic mental patients and their relation to the treatment with neuroleptics.” Int. J. Neuropsychiat., 3, 286–291.Google Scholar
7. Denber, H. D., and Bird, E. G. (1955). “Chlorpromazine in the treatment of mental illness. II. side effects and relapse rates.” Amer. J. Psychiat., 112, 465–468.CrossRefGoogle Scholar
8. Diamond, L. S., and Marks, J. D. (1960). “Discontinuance of tranquilizers among chronic schizophrenic patients receiving maintenance dosage.” J. nerv. ment. Dis., 131, 247–251.Google Scholar
9. Freeman, L. S., and Alson, E. (1962). “Prolonged withdrawal of chlorpromazine in chronic patients.” Dis. nerv. Syst., 23, 522–525.Google Scholar
10. Garfield, S., Gershon, S., Sletten, I., Neubauer, H., and Ferrel, E. (1966). “Withdrawal of ataractic medication in schizophrenic patients.” Ibid., 27, 321–325.Google Scholar
11. Goldsmith, J., and Drye, R. (1963). “Milieu as a variable in clinical drug research.” Ibid., 24, 742–745.Google Scholar
12. Good, W. W., Sterling, M., and Holzman, W. H. (1958). “Termination of chlorpromazine with schizophrenic patients.” Amer. J. Psychiat., 115, 443–448.CrossRefGoogle Scholar
13. Greiner, A. C., and Nicolson, G. A. (1964). “Pigment deposition in viscera associated with prolonged chlorpromazine therapy.” Canad. med. Ass. J., 91, 627–635.Google Scholar
14. Hamilton, M., Hordern, A., Waldrop, F. N., and Lofft, J. (1963). “A controlled trial on the value of prochlorperazine, trifluoperazine and intensive group treatment.” Brit. J. Psychiat., 109, 510–522.CrossRefGoogle Scholar
15. Hamilton, M., Smith, A. L., Lapidus, H. E., and Cadogen, E. P. (1960). “A controlled trial of thiopropazate dihydrochloride, chlorpromazine and occupational therapy in chronic schizophrenics.” J. ment. Sci., 106, 40–55.CrossRefGoogle Scholar
16. Hollister, L. E., and Kosek, J. G. (1965). “Sudden death during treatment with phenothiazine derivatives.” J. Amer. med. Ass., 192, 1035–1038.Google Scholar
17. Hughes, J. S., and Little, J. G. (1967). “An appraisal of the continuing practice of prescribing tranquillizing drugs for long-stay psychiatric patients.” Brit. J. Psychiat., 113, 867–873.Google Scholar
18. Hunter, R., Earl, G. J., and Thornicroft, S. (1964). “An apparently irreversible syndrome of abnormal movements following phenothiazine medication.” Proc. Roy. Soc. Med., 57, 758–762.Google Scholar
19. Judah, L. N., Josephs, Z. M., and Murphee, O. D. (1961). “Results of simultaneous withdrawal of ataraxics in 500 chronic psychotic patients.” Amer. J. Psychiat., 118, 156–158.CrossRefGoogle Scholar
20. Maroolis, L., and Goble, J. (1965). “Lenticular opacities with prolonged phenothiazine therapy.” J. Amer. med. Ass., 193, 95–97.Google Scholar
21. Meszaros, A. F., and Gallagher, D. L. (1958). “Measuring indirect effects of treatment on chronic wards.” Dis. new. Syst., 19, 167–172.Google Scholar
22. Olson, G. W., and Peterson, D. B. (1960). “Sudden removal of tranquilizing drugs from chronic psychiatric patients.” J. nerv. ment. Dis., 131, 252–255.Google Scholar
23. Prien, R. F., and Cole, J. O. (1968). “High dose chlorpromazine therapy in chronic schizophrenia.” Arch. gen. Psychiat., 18, 4, 482–495.CrossRefGoogle Scholar
24. Rathod, N. H. (1958). “Tranquillizers and patients∗∗∗’ environment.” Lancet, i, 611–613.Google Scholar
25. Richardson, H. L., Graupner, K. I., and Richardson, M. E. (1966). “Intramyocardial lesions in patients dying suddenly and unexpectedly.” J. Amer. med. Ass., 195, 254–260.Google Scholar
26. Rothstein, C. (1960). “An evaluation of the effects of discontinuation of chlorpromazine.” New Eng. J. Med., 262, 67–69.Google Scholar
27. Siddall, J. (1965). “The ocular toxic findings with prolonged and high dosage chlorpromazine intake.” Amer. med. Ass., Arch. Ophthal., 74, 460–464.Google Scholar
28. Wetterholm, D., Snow, H., and Winter, F. (1965). “A clinical study of pigmentary change in cornea and lens in chronic chlorpromazine therapy.” Ibid., 74, 55–56.Google Scholar
29. Whitaker, C. B., and Hoy, R. M. (1963). “Withdrawal of perphenazine in chronic schizophrenia.” Brit. J. Psychiat., 109, 422–427.CrossRefGoogle Scholar
30. Winkleman, N. M. (1957). “An appraisal of chlorpromazine.” Amer. J. Psychiat., 113, 961.Google Scholar
31. Zeller, W. W. (1956). “Use of chlorpromazine and reserpine in the treatment of emotional disorders.” J. Amer. med. Ass., 160, 179–185.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.