The natural course of schizophrenia and effective maintenance drug treatment.

The natural course of schizophrenia is poor; in the absence of consistently effective and broadly applied treatment, about two thirds of schizophrenic patients remain symptomatic. Antipsychotic drugs dramatically improve the prognosis of these patients, and there is limited evidence that the use of these drugs during an acute episode may improve a patient's long-term outcome. Continued administration of antipsychotic drugs significantly attenuates the relapse rate among schizophrenic patients; however, compliance with oral antipsychotic medication remains a problem in this population. Long-acting depot antipsychotic drugs have an obvious advantage in improving patient compliance, and there are some data that suggest that relapse rates may be lower in patients receiving depot drugs compared with oral drugs. Because of the greater assurance long-acting depot drugs provide about medication compliance, these drugs clearly have a significant role in the maintenance treatment of schizophrenic patients.