Relapse in schizophrenia

Jorgensen, P. Early signs of psychotic relapse in schizophrenia. Br. J. Psvchiatrv 172, 327-330, 1998. 

Swofford CD, Kasckow JW, Scheller-Gilkey G Inderbitzin LB (1996). Substance use a powerful predictor of relapse in schizophrenia. Schizophrenia Research, 20, 145-51... 

Csernansky J, Okamoto A. Risperidone vs haloperidol for prevention of relapse in schizophrenia and schizoaffective disorder. Presented at the Annual Meeting of the American College of Neuropsychopharmacology, Acapulco, December 12-16,1999. 

Schooler NR, Levine J, Severe JB. NIMH-PRB collaborative fluphenazine study group. Depot fluphenazine in the prevention of relapse in schizophrenia evaluation of a treatment regimen. Psychopharmacol Bull 1979 15 44-47. 

Herz M (1985) Prodromal symptoms and prevention of relapse in schizophrenia. J Clin... 

The causal relation between cannabis abuse and schizophrenia is controversial. Cannabis abuse, and particularly heavy abuse, can exacerbate symptoms of schizophrenia and can be considered as a risk factor eliciting relapse in schizophrenia (110). Chronic cannabis use can precipitate schizophrenia in vulnerable individuals (111). 

Weiden PJ, Olfson M. Cost of relapse in schizophrenia. Schizophr Bull 1995 21 419-429. 

Sellers EM, Naranjo CA, Harrison M, et al Diazepam loading simplified treatment of alcohol withdrawal. Clin Pharmacol Ther 34 822-826, 1983 Sharp CW Introduction to inhalant Abuse, in Inhalant Abuse A Volatile Research Agenda (NIDA Research Monograph 129). Edited by Sharp CW, Beuvais F, Spence R. Rockville, MD, National Institute on Drug Abuse, 1992, pp 1-10 Smelson DA, Losonczy MF, Davis CW, et al Risperidone decreases craving and relapses in individuals with schizophrenia and cocaine dependence. Can J Psychiatry 47 671-675, 2002... 

Since early detection and intervention in schizophrenia is important for maximizing outcomes, treatment with antipsychotic medications should begin as soon as psychotic symptoms are recognized. Antipsychotic medications are the cornerstone of therapy for people with schizophrenia, and most patients are on lifelong therapy since non-adherence and discontinuation of antipsychotics are associated with high relapse rates. If other symptoms are present such as depression and anxiety, these symptoms should also be aggressively treated. Additionally, psychosocial treatments should be used concomitantly to improve patient outcomes. 

Hunt GE, Bergen J Bashir M (2002). Medication compliance and comorbid substance abuse in schizophrenia impact on community survival 4 years after relapse. Schizo-prenia Research, 54, 253-64... 

Mantel-Haenszel test, the combined studies indicated a highly significant difference (c - 483 df = 1 p < 10 This finding represents overwhelming statistical evidence that in schizophrenia, antipsychotics prevent relapse. 

FIG. 5-6. Relapse rate of schizophrenic patients after 24 months on placebo. (From Prien RF, Cole JO, Belkin NF. Relapse in chronic schizophrenia following abrupt withdrawal of tranquilising medication. Br J Psychiatry 1969 115 679-686, with permission.)... 

TABLE 5-19. Percent clinically deteriorated or relapsed by current medication dose and length of hospitalization in schizophrenia... 

Kane JM, Carson WH, Saha AR, Saha AR, McQuade RD, Ingenito GG, Zumbroff DL, Ali MW (2002) Efficacy and safety of aripiprazole and haloperidol versus placebo in patients with schizophrenia and schizoaffective disorder. J Clin Psychiat 63 763-71 Kasper S, Lerman MN, McQuade RD, Saha A, Carson WH, Ali M, Archibald D, Ingenito G, Marcus R, Pigott T (2003). Efficacy and safety of aripiprazole vs. haloperidol for long-term maintenance treatment following acute relapse of schizophrenia. Int J Neuropsychopharmacol 6 325-37... 

Leff J, Vaughn C. 1981. The role of maintenance therapy and relatives expressed emotion in relapse of schizophrenia A two-year follow-up. Br J Psychiatry 139 102-124. 

Leucht S, Barnes TRE, Kissling W, Engel RR, Correll C, Kane JM. Relapse prevention in schizophrenia with new-generation antipsychotics a systematic review and exploratory meta-analysis of randomised, controlled trials. Am J Psychiatry 2003 160 1209-22. 

Glick ID, Berg PH. Time to study discontinuation, relapse, and compliance with atypical or conventional antipsycho-tics in schizophrenia and related disorders. Int Clin Psychopharmacol 2002 17(2) 65-8. 

Csernansky JG, Mahmoud R, Brenner R. Risperidone-USA-79 Study Group. A comparison of risperidone and haloperidol for the prevention of relapse in patients with schizophrenia. N Engl J Med 2002 346(l) 16-22. 

A 17-year-old man, with a history of paranoid schizophrenia and irregular abuse of cannabis and alcohol, took risperidone (202). Starting at 0.5 mg/day, the dose was titrated up to 4 mg/day over 3 weeks. In a few weeks, he stopped taking risperidone because of a recurrent inability to ejaculate, despite normal libido, erection, and sense of orgasm he also had difficulty in urinating. These effects disappeared after drug withdrawal. However, risperidone was restarted because of relapse of schizophrenia, and the ejaculatory disturbance recurred within a few days. 

Yui K, Ikemoto S, Goto K, Nishijima K, Yoshino T, Ishiguro T. Spontaneous recurrence of methamphetamine-induced paranoid-hallucinatory states in female subjects susceptibility to psychotic states and implications for relapse of schizophrenia. Pharmacopsychiatry 2002 35(2) 62-71. 

Approved to delay relapse in long-term treatment of schizophrenia... 

---