[Neuroleptic low-dose long-term strategy and intermittent therapy strategy in chronic schizophrenia--a critical...

Much effort has been devoted during the past decade in finding new therapeutic approaches to cope with the commonly occurring adverse side effects of long-term neuroleptic maintenance treatment of schizophrenics, such as, in particular, akathisia, parkinsonian symptoms and tardive dyskinesia. Both low-dose maintenance (e.g. long-term treatment at dosages reduced to one-fifth or even less of conventional dosage levels in remitted and stable schizophrenics) and intermittent or-target medication strategies (e.g. discontinuation of neuroleptics in remitted stable chronic schizophrenics, aimed at resuming the medication as soon as prodromal signs of a relapse or actual relapses occur) might eventually imply for many schizophrenics a substantial reduction in total long-term neuroleptic dosages. This may lead to a reduction in the incidence of side effects and to an improvement in social integration. A critical review of the results published so far arrives at the following conclusions: 1. low-dose maintenance therapy is just as effective as a standard dose regimen and even superior to intermittent (target) medication. Especially if the dosage is increased in case of exacerbations; 2. these results are representative for a very small group of patients only, since the study populations were highly selective.