POSSIBLE PREDICTORS OF NEUROLEPTIC-RESISTANT SCHIZOPHRENIC RELAPSE - INFLUENCE OF NEGATIVE SYMPTOMS AND ACUTE EXTRAPYRAMIDAL SIDE-EFFECTS

The relative efficacy of conventional treatment alternatives that are routinely used to treat acutely relapsed schizophrenic patients who ha ve failed an initial course of standard neuroleptic therapy has not be en adequately studied, nor have predictors of poor treatment response been reliably identified. We have recently reported preliminary findin gs that suggest that these patients may subsequently fail to respond t o such conventional alternative treatments as (1) maintaining the same dose of the neuroleptic over an extended trial, (2) significantly inc reasing the dose of the same neuroleptic, or (3) switching to a differ ent class of neuroleptic. Negative symptoms and acute extrapyramidal s ide effects (EPS) evident during the initial treatment trial were asso ciated with a less favorable clinical response to neuroleptic treatmen t. We now report on the association between clinical response and nega tive symptoms and acute EPS. Present findings suggest that a particula r degree of negative symptoms apparent prior to treatment may be assoc iated with a poor subsequent treatment response and that negative symp tom scores and EPS ratings demonstrate a significant correlation with severity of psychiatric ratings during the treatment trial. The relati onship among neuroleptic resistance, negative symptoms, and acute EPS requires further study.