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Pharmacological long-term treatment strategies in first episode schizophrenia

Study design and preliminary results of an ongoing RCT within the German Research Network on Schizophrenia
  • Wolfgang Gaebel
  • Hans-Jürgen Möller
  • Gerd Buchkremer
  • Christian Ohmann
  • Mathias Riesbeck
  • Wolfgang Wölwer
  • Martina von Wilmsdorff
  • Ronald Bottlender
  • Stefan Klingberg
ORIGINAL PAPER

Abstract.

In first-episode schizophrenia the advantage of new atypical neuroleptics compared to low-dose haloperidol as well as the indicated duration of neuroleptic maintenance treatment has still to be based on empirical evidence.

Accordingly, a multi-center study on the optimization of acute and long-term treatment in first-episode schizophrenia is currently being carried out as part of the German Research Network on Schizophrenia. This paper reports on the design, methods and preliminary results of the two-year randomized double-blind study comparing risperidone and low-dose haloperidol within the framework of psychological interventions. In the second treatment year, relapse rates under continued neuroleptic treatment are compared with those under stepwise drug withdrawal substituting instead prodrome-based early intervention (intermittent treatment).

As to the results, by November 2003 142 first episode patients (ICD-10 F20) have been included in the long-term study. One-year relapse rates were very low (3.8 %). On average, symptoms as well as drug side-effects decreased steadily under maintenance treatment. Although compliance on average was high, about 60% of the patients dropped out during the first study year. More pronounced psychopathology, (neurological) side-effects, lower compliance at study entry and absence of psychological treatment seemed to enhance the risk for drop-out.

In conclusion, treatment in first episode schizophrenia is effective under both (further on blinded) neuroleptics; however these patients are at high risk for treatment drop-out. This emphasizes the need for a special support program.

Key words

schizophrenia first episode long-term treatment atypical neuroleptics 

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Copyright information

© Steinkopff Verlag 2004

Authors and Affiliations

  • Wolfgang Gaebel
    • 1
  • Hans-Jürgen Möller
    • 2
  • Gerd Buchkremer
    • 3
  • Christian Ohmann
    • 4
  • Mathias Riesbeck
    • 1
  • Wolfgang Wölwer
    • 1
  • Martina von Wilmsdorff
    • 1
  • Ronald Bottlender
    • 2
  • Stefan Klingberg
    • 3
  1. 1.Department of Psychiatry and PsychotherapyHeinrich-Heine-University Düsseldorf, Rhineland State Clinics DüsseldorfDüsseldorfGermany
  2. 2.Department of PsychiatryLudwig-Maximilians-UniversityMunichGermany
  3. 3.Department of Psychiatry and PsychotherapyUniversity of TübingenGermany
  4. 4.Coordinating Center for Clinical TrialsHeinrich-Heine-UniversityDüsseldorfGermany

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