February 1981

Subjective Response to Antipsychotic Drugs

Author Affiliations

From the Veterans Administration Medical Center, Brentwood, Los Angeles (Drs Van Putten, May, Marder, and Ms Wittmann), and the Department of Psychiatry, UCLA (Drs Van Putten, May, and Marder).

Arch Gen Psychiatry. 1981;38(2):187-190. doi:10.1001/archpsyc.1981.01780270073010

• Sixty-three newly admitted schizophrenic patients were given a test dose of thiothixene and their subjective response was recorded by a technician blind to clinical ratings. All patients were then treated with thiothixene in an active milieu setting. Patients varied widely in their subjective responses. An initial dysphoric response was a powerful predictor of both immediate and eventual drug refusal. Before treatment, dysphoric responders tended to be less symptomatic and did significantly better on the Continuous Performance Test. Dysphoric responders experienced significantly more extrapyramidal symptoms following the test dose. Some dysphoric responders did have a good outcome when treated with very low doses. We recommend that patients with a history of dysphoric response be given a very low dose initially.