Gardos G, Cole J O
Am J Psychiatry. 1976 Jan;133(1):32-6. doi: 10.1176/ajp.133.1.32.
The serious long-term complications of maintenance antipsychotic therapy led the authors to undertake a critical review of outpatient withdrawal studies. Key findings included the following: 1) for a least 40% of outpatient schizophrenics, drugs seem to be essential for survival in the community; 2) the majority of patients who relapse after drug withdrawal recompensate fairly rapidly upon reinstitution of antipsychotic drug therapy; 3) placebo survivors seem to function as well as drug survivors--thus the benefit of maintenance drug therapy appears to be prevention of relapse; and 4) some cases of early relapse after drug withdrawal may be due to dyskinesia rather than psychotic decompensation. The authors urge clinicians to evaluate each patient on maintenance antipsychotic therapy in terms of feasibility of drug withdrawal and offer practical guidelines for withdrawal and subsequent management.
维持性抗精神病药物治疗的严重长期并发症促使作者对门诊撤药研究进行了批判性回顾。主要发现如下：1）对于至少40%的门诊精神分裂症患者而言，药物似乎是其在社区生存的关键；2）大多数撤药后复发的患者在重新使用抗精神病药物治疗后能较快恢复；3）安慰剂组康复者的功能似乎与药物组康复者相当——因此维持性药物治疗的益处似乎在于预防复发；4）撤药后早期复发的一些病例可能是由于运动障碍而非精神错乱。作者敦促临床医生根据撤药的可行性对接受维持性抗精神病药物治疗的每位患者进行评估，并提供撤药及后续管理的实用指南。
