Prevention of relapse in schizophrenia. An evaluation of fluphenazine decanoate

We tested the role of guaranteed delivery of medication in the prevention of relapse and the enhancement of adjustment in the community in patients with schizophrenia. Two hundred and ninety newly hospitalized patients at four hospitals were randomly assigned to groups receiving either long-acting injectable fluphenazine decanoate or short-acting oral fluphenazine hydrochloride. After discharge and stabilization, patients were treated in the community for up to one year. By the end of the year, 28% of all the patients had relapsed. Contrary to hypothesis, differences between the two treatment groups in relapse percentages were not significant. Furthermore, there were no differences between the treatment groups as to development of affective symptomatology or social adjustment. Patients who rated themselves as having more symptom distress at the start of the community-maintenance phase of the study relapsed much earlier while receiving fluphenazine decanoate rather than fluphenazine hydrochloride. The results suggest that compliance is not an important determinant of relapse among newly discharged schizophrenic patients.