Antipsychotic medication: clinical guidelines for maintenance therapy.

In neuroleptic maintenance therapy, first-illness schizophrenic patients should be prescribed continuing medication for at least one year. In the management of chronic schizophrenic patients following relapse, neuroleptic medication in standard oral doses or depot injections is recommended for periods in excess of 5 years to reduce the risk of relapse. Results are summarized from studies regarding drug therapy in conjunction with psychotherapeutic factors and family environment, the efficacy of lower dosage, benefit/risk ratios, and the advantages of long-term neuroleptic maintenance. The relationships of neuroleptic dose to plasma level and to therapeutic response are considered, as well as the implications of polypharmacy (e.g., use of anticholinergic drugs with neuroleptics).