Eleven years of experience with depot neuroleptics

The authors prescribe depot neuroleptics almost exclusively to chronic schizophrenics; the minimum duration of treatment is 6 months; 63% of long-acting neuroleptics are fluphenazine decanoate or flupentixol decanoate (main indication: inactive schizophrenics), 37% are clopentixol decanoate (main indication: productive and agitated schizophrenics). Safety, compliance and pharmacokinetics are much better with long-acting neuroleptics (LANs) than with oral medications, but the authors question the reality of a dose reduction as compared to oral neuroleptics since the latter are taken irregularly. The lowest possible dose and an increase of intervals between injections are advocated, because of less cumulative effects and less tardive dyskinesias. LANs bring about a quantitative reduction of symptomatology, but not a cure of the schizophrenic process: most patients relapse upon discontinuation.