Minimal maintenance medication: Effects of three dose schedules on relapse rates and symptoms in chronic schizophrenic outpatients
Our general hypothesis was that lower doses of antipsychotic agents than are usually employed may not only be adequate for the maintenance treatment of many schizophrenic patients but may also reduce the risk of neurotoxic effects. To explore the consequences of such dosage reductions, 94 chronic schizophrenic outpatients were randomly divided into three groups: 1) continuing on the regular maintenance dosage; 2) receiving medication reduced to the equivalent of 100 mg of chlorpromazine a day, and 3) receiving doses reduced to the equivalent of only 50 mg of chlorpromazine. An open clinical trial was conducted for 12 mo. The different rates of relapse during the 12-mo period were: 21.4% at the regular dose (mean = 609 mg/day); 32.2% at 100 mg, and 25.8% at 50 mg. These differences were not statistically significant, although there was bias encountered, suggesting that some less severely ill patients entered the lower dose groups. Nevertheless, our findings suggest that, in stabilized schizophrenic patients, even very low doses of antipsychotic maintenance medication may exert useful effects that we estimate to represent less than a half of the relapse rate expected in nonmedicated patients. In addition, lower doses of antipsychotic medication may exert other beneficial effects, possibly reflecting a reduction of extrapyramidal and other neurotoxic actions.
Lehmann, HE; Wilson, WH; Deutsch, M
Volume / Issue
Start / End Page