Neuroleptic Withdrawal in Schizophrenic Patients

Abstract

IN THIS issue of theArchives, Gilbert and her colleagues¹provide a scholarly, comprehensive meta-analysis of research concerning the discontinuation of neuroleptic treatment. We find that additional information can be obtained from their analyses, which adds to an emerging impression that abrupt withdrawal of neuroleptic drugs and other maintenance medications is associated with a high risk for early recurrence of acute illness. Their analysis involves a total of nearly 5600 psychotic patientsubjects in 66 studies reported between 1958 and 1993, including 29 paired comparisons with cohorts continued on treatment with medication. The results strongly indicate that the discontinuation of maintenance neuroleptic medication carries a significant early risk for severe exacerbation of illness ("relapse"), averaging 53% within 9.7 months after discontinuation vs 15.6% with continued medication. These results accord closely with a similar analysis of this literature up to the early 1980s, in which the risk after stopping neuroleptic treatment