Hostname: page-component-76fb5796d-dfsvx Total loading time: 0 Render date: 2024-04-25T10:40:19.341Z Has data issue: false hasContentIssue false

Schizophrenics Fully Remitted on Neuroleptics for 3–5 years—To Stop or Continue Drugs?

Published online by Cambridge University Press:  29 January 2018

Hung K. Cheung*
Affiliation:
South Kwai Chung Psychiatric Centre, South Kwai Chung Polyclinic, Kwai Shing, New Territories, Hong Kong

Summary

A double-blind comparison between benzodiazepines and neuroleptics was carried out for 1 ½ years on 30 schizophrenics who had hitherto continuously received neuroleptics and remained apparently in full remission for at least 3–5 years. The benzodiazepine-group had a significantly higher relapse rate than the neuroleptic-group, meaning that we cannot stop neuroleptics for these patients yet. Three possible reasons for this are (1) demand of the natural course of the illness, (2) the fact that the patients agreed to stay in therapy for so long may signify a need for therapy, (3) some of the relapses on stopping neuroleptics may be ‘withdrawal psychosis' after prolonged neuroleptic therapy. If withdrawal of neuroleptics is really needed, however, it may be considered for a subgroup of female patients whose illness started after the age of 40.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1981 

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

Affleck, J. W. (1976) Long-term follow-up of schizophrenic patients in Edinburgh. Acta Psychiatrica Scandinavica, 53, 227237.Google Scholar
Allon, R. (1971) Sex, race, socioeconomic status, social mobility and process-reactive ratings of schizophrenia. Journal of Nervous and Mental Disease, 153, 343350.CrossRefGoogle Scholar
Bland, R. C. & Orn, H. (1979) Schizophrenia: Diagnostic criteria and outcome. British Journal of Psychiatry, 134, 3438.Google Scholar
Chouinard, G. Jones, B. D. & Annable, L. (1978) Neuroleptic-induced supersensitivity psychosis. American Journal of Psychiatry, 135, 14091410.Google ScholarPubMed
Chouinard, G. Jones, B. D. (1980) Neuroleptic-induced supersensitivity psychosis: clinical and pharmacologic characteristics. American Journal of Psychiatry, 137, 1621.Google Scholar
Davis, J. M. (1975) Overview: maintenance therapy in psychiatry: I. Schizophrenia. American Journal of Psychiatry, 132, 12371245.Google Scholar
Edwards, J. H. (1960) The simulation of Mendelism. Acta genetica et statistica medica (Basel), 10, 63.Google Scholar
Feighner, J. P. Robins, E. Guze, S. B. Woodruff, R. A. Winokur, G. & Munoz, R. (1972) Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 5763.CrossRefGoogle ScholarPubMed
Forrest, A. D. (1976) Diagnosis and patient selection. British Journal of Clinical Pharmacology, Supplement, 367370.CrossRefGoogle Scholar
Forrest, A. D. & Hay, A. J. (1972) The influence of sex on schizophrenia. Acta Psychiatrica Scandinavica, 48, 4958.Google Scholar
Gibson, A. C. (1978) Depot injections and tardive dyskinesia. British Journal of Psychiatry, 132, 361365.Google Scholar
Guttmann, E. Mayer-Gross, W. & Slater, E. T. O. (1939) Short-distance prognosis of schizophrenia. Journal of Neurology and Psychiatry, 2, 25, 310312.Google Scholar
Hirsch, S. R. Gaind, R. Rhode, P. D. Stevens, B. C. & Wing, J. K. (1973) Outpatient maintenance of chronic schizophrenic patients with long-acting fluphenazine: double-blind placebo trial. British Medical Journal, i, 633637.Google Scholar
Hogarty, G. E. Goldberg, S. C. & The Collaborative Study Group (1973) Drug and sociotherapy in the aftercare of schizophrenic patients. One year relapse rates. Archives of General Psychiatry, 28, 5464.Google Scholar
Hogarty, G. E. Goldberg, S. C. Schooler, N. R. Ulrich, R. F. & The Collaborative Study Group (1974) Drug and sociotherapy in the aftercare of schizophrenic patients. II. Two-year relapse rates. III. Adjustment of non-relapsed patients. Archives of General Psychiatry, 31, 603618.Google Scholar
Hogarty, G. E. Ulrich, R. Mussare, F. & Aristigueta, N. (1976) Drug discontinuation among long-term successfully maintained schizophrenic out-patients. Diseases of the Nervous System, 57, 494500.Google Scholar
Johnson, D. A. W. (1978) The prevalence and treatment of drug-induced extrapyramidal symptoms. British Journal of Psychiatry, 132, 2730.Google Scholar
Johnson, D. A. W. (1979) Further observations on the duration of depot neuroleptic maintenance therapy in schizophrenia. British Journal of Psychiatry, 135, 524530.Google Scholar
Johnson, D. A. W. & Breen, M. (1979) Weight changes with depot neuroleptic maintenance therapy. Acta Psychiatrica Scandinavica, 59, 525528.Google Scholar
Kellner, R. & Sheffield, B. F. (1973) A self-rating scale of distress. Psychological Medicine, 3, 88100.Google Scholar
Leff, J. P. & Wing, J. K. (1971) Trial of maintenance therapy in schizophrenia. British Medical Journal, iii, 599604.Google Scholar
Lo, W. H. & Lo, T. (1977) A ten-year follow-up study of Chinese schizophrenics in Hong Kong. British Journal of Psychiatry, 131, 6366.Google Scholar
National Institutes of Mental Health Psychopharmacology Service Centre Study Group (1964) Phenothiazine treatment in schizophrenia. Archives of General Psychiatry, 10, 246261.CrossRefGoogle Scholar
Offord, D. R. (1974) School performance of adult schizophrenics, their siblings and age mates. British Journal of Psychiatry, 125, 1219.Google Scholar
Parkes, C. M. (1963) Interhospital and intrahospital variations in the diagnosis and severity of schizophrenia. British Journal of Preventive and Social Medicine, 17, 8589.Google ScholarPubMed
Preen, R. Cole, J. O. & Belkin, N. (1968) Relapse in chronic schizophrenics following abrupt withdrawal of tranquillizing medication. British Journal of Psychiatry, 115, 679686.Google Scholar
Rennie, T. A. C. (1939) Follow-up study of 500 patients with schizophrenia admitted to the hospital from 1913–1923. Archives of Neurology and Psychiatry, 42, 877, 310312.Google Scholar
Richardson, H. L. (1966) Intramyocardial lesions in patients dying suddenly and unexpectedly. Journal of American Medical Association, 195, 254260.Google Scholar
Rubin, M. & Slonicki, A. (1967) A proposed mechanism for the skin-eye syndrome. In: Neuropsychopharmacology, ed. Brill, H. International Congress Services, No. 129. Excerpta Medica Foundation, Amsterdam, pp. 661679.Google Scholar
Shields, J. (1967) The genetics of schizophrenia in historical context. In: Recent Developments in Schizophrenia. (eds. Coppen, A. and Walk, A.). British Journal of Psychiatry, Special Publication No. 1.Google Scholar
Slater, E. & Cowie, V. (1971) The Genetics of Mental Disorders. London: Oxford University Press.Google Scholar
Vedrine, J. (1967) Les hyperthermics lièes à l'administration des neuroleptiques. In: Actualite du Therapeutique Psychiatrique. (ed. Lamber, ). Paris: Masson. Pp 332350.Google Scholar
Wing, J. K. Monck, E. Brown, G. W. & Carstairs, G. M. (1964) Morbidity in the Community of Schizophrenic patients discharged from London Mental Hospitals in 1959. British Journal of Psychiatry, 110, 10, 310339.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.