How high is the relapse rate in schizophrenia?

Although maintenance neuroleptic treatment reduces the risk of relapse in schizophrenia, that risk remains substantial. Maintenance neuroleptics following first schizophrenic episodes are valuable in reducing the relapse rate but may be associated with occupational disadvantage. In first episodes the early introduction of neuroleptic treatment may be important in later reduction of relapse rate. Response to placebo during a psychotic episode does not predict sustained wellbeing without neuroleptics. Long-term follow-up indicates that some schizophrenic patients will remain relapse-free and that there are patients who remain well without neuroleptics, but it is not possible to select those for whom prophylactic neuroleptics will not reduce the risk of relapse.