Schizophrenia relapse in relation to drug treatment

Objectives: To assess and compare, prospectively,schizophrenia relapse in relation to neurolepticmedication in long term maintenance therapy.Methods: All schizophrenic patients who met theDSM-IV criteria attending King Khalid UniversityHospital psychiatry outpatient clinic, Riyadh, Kingdomof Saudi Arabia in January 1994, and who fulfilled theinclusion criteria of the study, were assessed at baselineusing the brief psychiatric rating scale (BPRS), quality oflife scale and the extrapyramidal rating scale, and at eachrelapse and 6 weeks after treatment of the relapse andfollowed for 10 years after being allocated to one of 3groups of neuroleptic medications depot (group A),conventional (group B) and atypical, clozapine (group C).A data collection form including sociodemographic dataand other clinical indices was also completed for thepatients.Results: Seventy-six schizophrenic patients met theDSM-IV diagnostic criteria, but only 59 patients fulfilledthe inclusion criteria of the study and 4 patients quit thestudy. The mean age was 27.45 years and 63.6% weremales and 98.2% were Saudis. There was a statisticalsignificance of the BPRS scores before and after relapsefor groups A and C, but not for group B. The relapserates at one year, 2 years, 3 years, and 5 years were in therange 13.3-34.6% for groups A and C but much higher at35.7-85.7% for group B.Conclusion: Relapse rate in schizophrenia can bemarkedly reduced by effective maintenance neuroleptictreatments adhered to by the psychiatrist leaving moreroom for further reduction of relapse by implementingother measures such as lowering the expressed emotion,psychoeducation and rehabilitation. Further long-termlarge sample research is needed to affirm this.