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March 1995

Considering Neuroleptic Maintenance and Taper on a ContinuumNeed for Individual Rather Than Dogmatic Approach

Author Affiliations

Department of Psychiatry University of California, San Diego San Diego Veterans Affairs Medical Center 116A 3350 La Jolla Village Dr San Diego, CA 92161
This work was supported, in part, by the Department of Veterans Affairs and by grants MH45131, MH43693, MH49671-01, and MH51459 from the National Institute of Mental Health. We thank Nina Schooler, PhD, and George Simpson, MD, for helpful discussions prior to the preparation of the manuscript.

Arch Gen Psychiatry. 1995;52(3):209-212. doi:10.1001/archpsyc.1995.03950150041008

What is the nature of the bioelectrical and biochemical perturbations... which constitute the physical ground of psychotic states? How do our drugs act on these perturbations? It is difficult at present to take a stand, since later on it might be absolutely senseless on a more refined plane. Henri Laborit (1960)1

The ABOVE statement by the French surgeon who discovered the psychotropic effects of chlorpromazine is still valid 35 years later. While we know a lot more today about the pathophysiology of schizophrenia and other psychoses and about the mechanism of action of neuroleptic drugs than we did in 1960, there is yet much more that is unknown. Our lack of adequate understanding in these areas is reflected clinically in the history of wide fluctuations in the practice of neuroleptic use over the past four decades. In the years following the introduction of neuroleptic drugs into psychiatric practice, these drugs

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