The outpatient clinic for patients under chronic lithium or neuroleptic treatment as a phase-IV research tool.

Psychiatric drug treatment often means life-long therapy Controlled long-term drug trials in psychiatric patients over periods of more than three years, however, do not exist. Organisational and ethical reasons prohibit placebo controlled or even standard drug controlled trials over periods of one decade and more. The present paper illustrates the methodology and scientific significance of well-documented long-term follow-up studies by example of the structure and scientific results of two outpatient clinics: (1) a schizophrenic outpatient clinic taking care of approximately 200 patients of whom a subgroup has been treated with perazine for now 18 years on the average; (2) a lithium clinic taking care of approximately 100 actively participating patients.--It is suggested that this kind of "naturalistic" open trials, set up in accordance with conditions normally occurring in psychiatric practice, are a necessary complement to other controlled methodologes.