A study of the pharmacologic treatment of medication-compliant schizophrenics who relapse

Maintenance antipsychotic medications greatly diminish the risk of relapse in schizophrenic patients. A significant number, however, will relapse despite ongoing drug treatment. This is a report of a pilot study of a group of schizophrenic patients who relapsed despite having been compliant with treatment.

The authors studied 32 schizophrenic patients who had been compliant with pharmacologic treatment but who had suffered a relapse and were admitted to the hospital. Maintained on their usual pharmacologic treatment, they also received in a double-blind fashion either fluphenazine or placebo. Clinical assessments were done on Day 1 and Day 10.

The authors found no effect of additional neuroleptic treatment on outcome. Two-thirds of the subjects showed at least moderate improvement during the study. Subjects who were experiencing greater severity of depression on admission were more likely to improve. There was no association between baseline ratings of psychosis and outcome.

This study offers preliminary evidence that increasing the dose of neuroleptic does not improve outcome in schizophrenics who have relapsed while taking antipsychotic medications. Most of these patients will improve during the course of a brief hospitalization.