REDUCING THE DOSE OF DEPOT NEUROLEPTICS IN STABLE SCHIZOPHRENIA

In order to determine the safety of reducing maintenance neuroleptic d ose in long-term ambulatory schizophrenia, a step-wise depot reduction study was carried out on patients over a six month period. Doses were reduced by 1/8 of original approximately every two months for a total of three reductions. At the end of dose reduction and at six month fo llow-up, relapse rate was calculated. Relapse in this study was define d as the clinical decision to either increase neuroleptic dose or to h ospitalize. Approximately 50% of the patients relapsed. There was no a ssociation with life events as measured by the Paykel scale. Where rel apse occurred, it was usually seen subsequent to the second dose reduc tion. Patients who survived dose reduction had been maintained for a s ignificantly longer period on depot neuroleptics and tended to suffer from a form of schizophrenia which required the co-administration of a ntidepressants. The findings show that, for a population on long-term depot medication, the risk of symptom exacerbation after gradual step- wise neuroleptic reduction is 50%. The results help to delineate which patients will fall into that 50%.