Neuroleptic discontinuation in the very stable schizophrenic patient: Relapse rates and serum neuroleptic levels

Abstract

AbstractThis double‐blind, placebo‐controlled study investigated the effect of discontinuation of maintenance neuroleptic medication in chronic, long‐stay schizophrenic patients who had been clinically stable for over 5 years. After 12 months, 75 per cent of the patients on placebo had relapsed as compared to 33 per cent on active medication and relapses in the placebo group occurred significantly earlier during the study; survival analysis revealed the differences to be statistically significant. No clear predictors of relapse could be identified, although patients who relapsed from either group were more likely to have had higher scores for anxiety symptoms and a lower serum prolactin level at baseline. It was concluded that even in older patients who have been chronically ill with prominent negative symptoms and living in a relatively undemanding environment on stable doses of neuroleptics, the risk of relapse remains unacceptably high after abrupt withdrawal of maintenance neuroleptic therapy.