Am J Psychiatry 1976; 133:32-36
Copyright © 1976 by American Psychiatric Association
Maintenance antipsychotic therapy: is the cure worse than the disease?
G Gardos and JO Cole
The serious long-term complications of maintenance antipsychotic therapy
led the authors to undertake a critical review of outpatient withdrawal
studies. Key findings included the following: 1) for a least 40% of
outpatient schizophrenics, drugs seem to be essential for survival in the
community; 2) the majority of patients who relapse after drug withdrawal
recompensate fairly rapidly upon reinstitution of antipsychotic drug
therapy; 3) placebo survivors seem to function as well as drug
survivors--thus the benefit of maintenance drug therapy appears to be
prevention of relapse; and 4) some cases of early relapse after drug
withdrawal may be due to dyskinesia rather than psychotic decompensation.
The authors urge clinicians to evaluate each patient on maintenance
antipsychotic therapy in terms of feasibility of drug withdrawal and offer
practical guidelines for withdrawal and subsequent management.
