EFFECTS OF NEUROLEPTIC REDUCTION IN SCHIZOPHRENIC OUTPATIENTS RECEIVING HIGH-DOSES

This paper presents an open study which evaluated the clinical effects of a partial and progressive reduction in neuroleptic medication in 3 2 outpatients suffering from schizophrenia who were receiving high dos es (equivalent of greater-than-or-equal-to 18 mg of oral haloperidol p er day; EHL). After an observation period of twelve weeks, each subjec t's dose of neuroleptics was reduced by 50% at the rate of 10% every f our weeks. Patients were receiving a mean of 62 mg per day EHL at the beginning of the study and 30 mg per day EHL at the completion of the study. After the reduction, the following was observed: 1. a significa nt but modest change in psychopathology: a decrease in negative sympto ms and in the total score on Brief Psychiatric Rating Scale; and 2. a significant increase in tardive dyskinesia symptoms. Six subjects rela psed but five of them recovered without increasing their reduced medic ation. Results of this study are discussed in the context of trying to find a minimal maintenance dose in the treatment of schizophrenia. Th e relative paucity of change despite a large reduction in medication a rgues for reevaluation of dosage in patients on high or very high dose s of neuroleptics. The results suggest that many patients taking high doses could be maintained on significantly lower doses of neuroleptics . With gradual reduction of medication it would seem that many patient s who are receiving a high dose of neuroleptic can achieve a lower dos e than their current maintenance level.