Early intervention, time-limited, targeted pharmacotherapy of schizophrenia.

A growing appreciation of the risks of long-term, continuous neuroleptic use in the aftercare of schizophrenic patients has led to a search for alternative strategies. The authors report their experiences with the clinical strategy of "targeted" medication, in which patients are followed drug free until prodromal signs of impending relapse appear. Medication is then initiated to abort the impending episode and discontinued when patients restabilize clinically. Preliminary experience suggests that control of schizophrenic symptomatology comparable to that obtained with maintenance drugs can be achieved with a marked reduction in medication use when the targeted strategy is applied in the context of a broad-based program of psychosocial intervention based on a comprehensive medical model.