[Drug treatment of schizophrenic patients]

Pharmacotherapy of schizophrenia is a complex matter. Neuroleptics play a dominant role in the acute stage. They have to be complemented however by psycho- and sociotherapeutic measures. In particular when negative symptoms prevail drugs can worsen the course of the disease. In contrast to earlier opinions calling for high-dose treatment, recent studies have demonstrated effectiveness of low- or medium-dose regimens that carry a lower risk of side effects. Six to 18 mg of haloperidol per day constitute an effective neuroleptic dose. Higher doses are in addition sedating. In the course of a treatment the lowest effective dose has to be sought continuously. Complications such as depressive dysphoric states should before all encourage to consider and rule out overdosage. Long term compliance depends crucially on avoidance of undesired or adverse effects of medication, in particular during induction treatment.