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Lower-Dose Therapy With Traditional Neuroleptics in Chronically Hospitalized Schizophrenic Patients

Robert C. Smith, MD, PhD
Arch Gen Psychiatry. 1994;51(5):427-429. doi:10.1001/archpsyc.1994.03950050087011.
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Several recent studies have shown that relatively low doses and low blood levels of neuroleptics are often as effective as high doses of these drugs both in the treatment of an acute exacerbation of schizophrenia1-3 and in the maintenance treatment of stabilized outpatients with schizophrenia.4,5 Yet, some patients with chronic schizophrenia or related disorders, hospitalized for extended periods, are treated with relatively high doses of neuroleptics for many years. The efficacy of low doses vs standard or high doses of traditional neuroleptics in this group of patients has not been extensively investigated and thus represents an important gap in the low-dose research and treatment strategy. This letter reports an attempt to address this important clinical question.

Patients and Methods.  In the course of clinical management of a service of chronically psychotic female patients, a program of neuroleptic dosage reduction combined with quantitative monitoring of their psychopathologic condition was


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