The discontinuance of maintenance neuroleptic therapy in chronic schizophrenic patients: drug and social consequences

Abstract

- In a prospective follow-up the outcome of 60 chronic schizophrenic patients who discontinued neuroleptic therapy after remaining stable 12–48 months was compared with controls continuing medication. Not only did the drug-discontinued patients have more relapses (P < 0.001), but the form of relapse was both more severe and acute, resulting in differences of self-injury (P < 0.05), anti-social behaviour (P < 0.01), inpatient admissions (P < 0.001), and the use of compulsory powers (P < 0.01). In patients who relapsed, both social and work function was affected adversely for some months. Patients who remained relapse-free without drugs (20%) had a level of work and social function similar to medicated patients. At the end of 18 months the patients who discontinued depot maintenance therapy were found to have been prescribed one-third more neuroleptic drugs than controls, with a possible increase in the risk of long-term tardive dyskinesia.