Long-term Antipsychotic Treatment: Effective and Often Necessary, with Caveats


Recently, the blogosphere has been buzzing with controversy regarding the use of maintenance antipsychotic treatment.1,2 On the one hand, most psychiatrists who have treated severely impaired patients with schizophrenia have little doubt that long-term antipsychotic (AP) treatment is both effective and necessary, in order to avoid relapse of psychotic illness. On the other hand, a few recent studies seem to cast doubt on this belief, and a number of psychiatry’s critics have seized upon these studies to argue against long-term AP use—even declaring that, in the long run, APs worsen psychosis and clinical outcome for those with schizophrenia.1,2

This article is by no means a comprehensive review of the voluminous, decades-old literature on AP maintenance; rather, it is a commentary on some recent studies and their sometimes controversial interpretation. I would argue that interpreting these complex studies requires an in-depth understanding of medical research design, psychopharmacology, and the numerous confounds that can affect treatment outcome. Unfortunately, a lack of medical training has not stopped a few critics from confidently charging that psychiatrists are harming their patients by prescribing long-term AP treatment.1,2


    85% success rate

Let’s rewrite proven, tested treatments of complex brain disorders with little other options based on the whims of the erratic blogosphere. Hmm…