Phenothiazine Reduction As a Cause of Rehospitalization

Abstract

WE RECENTLY studied a group of schizophrenic outpatients to find out if reduction in phenothiazine dosage, ordered by a physician, is a significant cause of readmission to a hospital. Previous controlled studies have shown the deleterious effect, in schizophrenia, of withdrawing phenothiazines.^1-8 Some of these have been of the type where the phenothiazine was withdrawn and replaced by a placebo^1-7 with the patient's physician remaining "blind." In several of these studies readmission to a hospital has been used as a criterion of deterioration.^2-4,8 It might be supposed that when the reduction in dosage is deliberately ordered by a physician, the deleterious results would be less likely than when the drug is capriciously stopped as part of a double-blind, placebo-controlled, experiment. (Analogy with other drugs, such as digitalis for heart failure, or steroids for rheumatoid arthritis, would certainly suggest this.) Forrest, however, has