Low serum neuroleptic levels predict relapse in schizophrenic patients.
Relapse occurs in a substantial proportion of schizophrenic patients treated with neuroleptics. The determinants of relapse have been elusive. In our study, low serum neuroleptic levels identified patients who had a relapse during a six-month period. Neuroleptic levels were measured by radioreceptor assay in 61 schizophrenic men and their clinical status was assessed in the subsequent six months. Ten patients had relapses, four showing a worsening of chronic psychotic symptoms and six showing eruption of psychotic symptoms after a period of remission. These ten patients had significantly lower normalized neuroleptic levels than those whose conditions remained stable. The lowest neuroleptic levels occurred in patients who had relapses after a period of remission. Serum neuroleptic levels in drug-responsive patients appear to be a critical determinant of remission. If these observations are replicated, a rational basis may be provided for prescribing and monitoring neuroleptic treatment and perhaps for preventing relapse.
D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000097:blood* / Q000627:therapeutic use; D002746:Chlorpromazine / Q000097:blood / Q000627:therapeutic use; D005476:Fluphenazine / Q000097:blood / Q000627:therapeutic use; D006220:Haloperidol / Q000097:blood / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010546:Perphenazine / Q000097:blood / Q000627:therapeutic use; D012008:Recurrence; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D013881:Thioridazine / Q000097:blood / Q000627:therapeutic use; D014268:Trifluoperazine / Q000097:blood / Q000627:therapeutic use
D014150:Antipsychotic Agents; D014268:Trifluoperazine; D010546:Perphenazine; D006220:Haloperidol; D013881:Thioridazine; D005476:Fluphenazine; D002746:Chlorpromazine