Long term outcome of treating schizophrenia

Schizophrenia is one of the most disabling of mental illnesses, affecting one in 100 people in their lifetime, some 80% of whom will experience chronic or relapsing symptoms.1 What do we really know about its long term treatment?

The guidelines on schizophrenia issued by the National Institute for Clinical Excellence (NICE) describe antipsychotic drugs as “an indispensable treatment option for most people in the recovery phase of schizophrenia,”2 and a recent meta-review of depot antipsychotic injections considered them to be an effective maintenance treatment.3 Conventional antipsychotics (those acting via dopamine blockade, such as chlorpromazine or haloperidol), introduced in the 1950s, increased the proportion of patients who improved clinically noticeably from 35.4% to 48.5%.4 Because of their mode of action these drugs generated serious side effects, such as parkinsonism or hyperprolactinaemia; hence new generation, atypical antipsychotic agents (such as clozapine, olanzapine, risperidone, quetiapine) have been used (and sold) increasingly since the mid-1990s.

Acting …