Clinical use of the antipsychotics.

Neuroleptics are the cornerstone for both the acute treatment and prevention of most schizophrenic episodes. The authors review the current practical information available for the clinical management of acute episodes and maintenance therapy, including dosage schedules, plasma level determinations, and side effects. All neuroleptics given in equivalent doses produce approximately the same degree of antipsychotic activity. The most common cause of treatment failure in acute psychosis is an inadequate dose, and the most common cause of relapse is patient noncompliance. Maintenance medication should be given at the lowest dose that will sustain improvement. The authors also discuss several new alternative drug treatments to neuroleptics.