LONG-TERM CLINICAL AND SOCIAL OUTCOME STUDIES IN SCHIZOPHRENIA IN RELATION TO THE COGNITIVE AND EMOTIONAL SIDE-EFFECTS OF ANTIPSYCHOTIC-DRUGS

Evaluation of neuroleptics should include not only the effects on symp toms but also social functioning and the quality of life. Akathisia, c ognitive and emotional impairment (cognitive and emotional parkinsonis m) are probably the most important reasons for lack of compliance with classical neuroleptics. Atypical neuroleptics such as clozapine and r emoxipride offer an advantage because of little impairment of cognitiv e and emotional functioning. In 122 schizophrenic and schizoaffective therapy-resistent patients treated with clozapine for up to 17 years, the treatment was stopped in only 8 cases (7%) because of lack of comp liance. In patients treated for more than 2 years, 40% were employed a nd functioned well socially. It is concluded that, in many schizophren ic patients, atypical neuroleptics should be preferred in long-term ma intenance treatment because of a low incidence of extrapyramidal syndr omes as well as cognitive and emotional parkinsonism. An ''awakening'' is often seen when changing from a classical neuroleptic to an atypic al one.