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Neuroleptics and the Natural Course of Schizophrenia
Abstract
To determine if neuroleptic treatment changes the natural course of schizophrenia, 22 studies were reviewed in which relatively similar patients were or were not given neuroleptics at specific times during the course of their illness. Nineteen of the studies were from first- or predominantly first-break populations. While there was little consensus among the authors of the studies reviewed, a reanalysis of the data indicates that early intervention with neuroleptics in first-break schizophrenic patients increases the likelihood of an improved long-term course. This finding is similar to that of earlier investigators who indicated there was a decrease in patients with the more severe forms of the illness following the introduction of convulsive therapies. Furthermore, there is evidence that stable schizophrenic patients whose neuroleptics are discontinued and have relapses may have a difficult time returning to their previous level of function. The findings describe in this paper have implications for both the treatment of schizophrenia and for understanding the pathophysiological processes that determine the course of the disorder.
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“The notion that schizophrenia pathology worsen over time is supported by studies that suggest that long-term morbidity increases in the absence of any treatment 45,46 .”
From Developmental timing and critical windows for the treatment of psychiatric disorders (2016) · cites this paper as [45]
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Chapter 19. Suicide Risk, Assessment, and Intervention in Early Psychosis
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Chapter 14. Substance Use and Early Psychosis
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Chapter 8. Assessment and Targeted Intervention in Individuals at Clinical High Risk for Psychosis
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Chapter 16. Supported Employment and Education for People in Early Psychosis
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Chapter 17. Implementing Peer Support in Early Psychosis Programs
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Chapter 23. Special Populations: College and University Students
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Chapter 9. Medical Workup for First-Episode Psychosis
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Chapter 12. Psychopharmacology for People in Early Psychosis
Zhang, J., & Noordsy, D. L. (2019) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379217.lg12
Chapter 21. Inpatient Care for Early Psychosis
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Chapter 20. Using Technology to Advance Early Psychosis Intervention
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Chapter 2. Growth of Early Intervention in Psychosis in the United States
Hardy, K. V., Ballon, J. S., Noordsy, D. L., & Adelsheim, S. N. (2019) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379217.lg02
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Larrauri, C. A., & Garrett, C. (2019) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379217.lg05
Chapter 7. Assessment of People in the Early Stages of Psychosis
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Chapter 4. Early Intervention and Policy
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Chapter 22. Care for Adolescents on the First-Episode Psychosis Continuum
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Metadata
- Authors
- Wyatt, R. J.
- Affiliations
- St. Elizabeths Hospital (US)
- Corresponding author
- Wyatt, R. J.
- Venue
- Schizophrenia Bulletin
- Publisher
- Oxford University Press (OUP)
- Published
- 1991-01-01
- Volume
- 17
- Issue
- 2
- Pages
- 325-351
- ISSN
- 0586-7614 (ISSN-L)
- 1745-1701
- OpenAlex
- W2120012268
- Cited by
- 787
- References
- 73
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 8 · 2023: 5 · 2022: 4 · 2021: 21 · 2020: 12 · 2019: 48 · 2018: 14 · 2017: 18 · 2016: 17 · 2015: 17 · 2014: 18 · 2013: 22 · 2012: 27
- FWCI
- 13.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Schizophrenia Bulletin (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- schizophrenia, antipsychotic drugs
- MeSH terms
- Humans, Recurrence, Schizophrenia, Time Factors, Antipsychotic Agents
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