NEUROLEPTIC LOW-DOSE MAINTENANCE AND TARG ET MEDICATION STRATEGIES FOR CHRONIC-SCHIZOPHRENICS - A CRITICAL-REVIEW

Much effort has been devoted during the past decade in finding new the rapeutic approaches to cope with the commonly occurring adverse side e ffects of long-term neuroleptic maintenance treatment of schizophrenic s, such as, in particular, akathisia, parkinsonian symptoms and tardiv e dyskinesia. Both low-dose maintenance (e.g. long-term treatment at d osages reduced to one-fifth or even less of conventional dosage levels in remitted and stable schizophrenics) and intermittent or-target med ication strategies (e.g. discontinuation of neuroleptics in remitted s table chronic schizophrenics, aimed at resuming the medication as soon as prodromal signs of a relapse or actual relapses occur) might event ually imply for many schizophrenics a substantial reduction in total l ong-term neuroleptic dosages. This may lead to a reduction in the inci dence of side effects and to an improvement in social integration. A c ritical review of the results published so far arrives at the followin g conclusions: 1 .low-dose maintenance therapy is just as effective as a standard dose regimen and even superior to intermittent (target) me dication. Especially if the dosage is increased in case of exacerbatio ns; 2. these results are representative for a very small group of pati ents only, since the study populations were highly selective.