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Sept 1982

Low Serum Neuroleptic Levels Predict Relapse in Schizophrenic Patients

Author Affiliations

From the Veterans Administration Medical Center (Drs Brown and Laughren, Ms Chisholm, and Mr Williams) and the Brown University Program in Medicine (Drs Brown and Laughren), Providence, RI.

Arch Gen Psychiatry. 1982;39(9):998-1000. doi:10.1001/archpsyc.1982.04290090008002

• Relapse occurs in a substantial proportion of schizophrenic patients treated with neuroleptics. The determinants of relapse have been elusive. In our study, low serum neuroleptic levels identified patients who had a relapse during a six-month period. Neuroleptic levels were measured by radioreceptor assay in 61 schizophrenic men and their clinical status was assessed in the subsequent six months. Ten patients had relapses, four showing a worsening of chronic psychotic symptoms and six showing eruption of psychotic symptoms after a period of remission. These ten patients had significantly lower normalized neuroleptic levels than those whose conditions remained stable. The lowest neuroleptic levels occurred in patients who had relapses after a period of remission. Serum neuroleptic levels in drugresponsive patients appear to be a critical determinant of remission. If these observations are replicated, a rational basis may be provided for prescribing and monitoring neuroleptic treatment and perhaps for preventing relapse.