Neuroleptic drugs prevention

Patients who have had two or more schizophrenic episodes should receive maintenance therapy for at least five years, and some experts prefer indefinite therapy. Low doses of antipsychotic drugs are not as effective in preventing relapse as higher dose maintenance therapy (Figure 13.7). Figure 13.8 summarizes the therapeutic uses of the neuroleptic drugs. 

The main indications for atypical antipsychotics are the acute and maintenance treatment of schizophrenic disorders, with an emphasis on the treatment of refractory and chronic disorders. However, because of the lower risk of EPS and in particular of tardive dyskinesia, there is a tendency toward a wider range of indications for some of the atypical neuroleptics. Favorable effects in drug-induced psychoses have been demonstrated for olanzapine. Clozapine seems effective in the treatment and relapse prevention of manic episodes and bipolar disorders, and risperidone has been shown to have good efficacy in conduct disorders and in the pervasive developmental disorders. 

Velamoor VR. Neuroleptic malignant syndrome. Recognition, prevention and management. Drug Saf 1998 19(l) 73-82. 

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