Long-Term Drug Treatment of Psychosis: Observations on some Current Issues

The drugs available for the treatment of psychosis are reviewed. Comment is made upon the pharmacology and clinical actions of these drugs. The clinical treatment and management of both first illness schizophrenia and chronic schizophrenia is examined in some detail. It is emphasized that drug treatments should be prescribed only after a careful examination of the risk-benefit ratio for the particular patient. The relative risks of relapse are reviewed, with particular comment on the true meaning of a relapse for both patient and society. Mention is also made on the current thinking about the duration of maintenance therapy. The side effects of drugs described and the current treatment strategies suggested to overcome these difficulties are discussed. Attention is drawn to the common problem of polypharmacy and some of the reasons for this are explored. The problem of depression in schizophrenia is discussed and recommendations on management are made.