[Treatment of schizophrenia]

Efficacy of neuroleptic treatment is well recognized in the treatment of schizophrenia. Both "Practice Guideline of Paris" (1994) and "the Practice Guideline of the APA" (1997) could advise psychiatrists in the choice of therapeutic strategies. The early recognition and management of a first episode of schizophrenia and the maintenance of antipsychotic medication at lower doses (for at least one year after a first episode, and five years after two or more relapses) seem to influence positively the long-term outcome of the disease. Despite the advantages of atypical neuroleptics with regard to extrapyramidal symptoms and their clinical efficacy in the short term treatment of schizophrenia, these treatments induce other side effects (cardiovascular or metabolic) that need to be further investigated; in addition, their long-term efficacy has not been adequately studied.