The use of depot neuroleptics: clinical experience in the United States.

The use of long-acting injectable preparations such as fluphenazine enanthate or decanoate can reduce patient noncompliance, but documenting this in a controlled research design is difficult. Several studies of relapse rates among patients receiving oral fluphenazine, depot fluphenazine, or placebo are reviewed. Factors that may explain the lack of significant differences among different drug treatments in preventing relapse are discussed. Indications are presented for the use of depot neuroleptics, and strategies for achieving minimum effective doses are reviewed. Adverse effects of depot medication are also discussed, so that the clinician may maximize the ratio of benefit to risk.