Suspension of neuroleptic therapy in acute schizophrenia

What are the effects of the abrupt discontinuation of neuroleptics (suspension therapy) in acutely schizophrenic patients with unsatisfactory remission under standard neuroleptic therapy? This question was investigated in a prospective study of 159 patients. In addition to the psychopathologic results of the AMDP system, the self rating (VAMS) and nurses' rating (NGI) of psychopathologic parameters were assessed. Indication for suspension of the neuroleptic treatment was established in 21 patients (13%) following definite criteria. Suspension therapy brings about a rapid improvement in psychopathologic results. The paranoid-hallucinatory syndrome also undergoes remission; this is to be understood as an immediate effect of suspension of therapy. In one-third of the cases complete suspension effects, in another third partial suspension effects, and in the remaining third failure occur. Further advantages of suspension therapy are the reduction in neuroleptic drug requirements and a favorable influence on the entire treatment course. The investigation does not permit any statement as regards prediction of the suspension effect or concerning the mechanism underlying the suspension therapy.