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September 1988

Dose of Fluphenazine, Familial Expressed Emotion, and Outcome in Schizophrenia: Results of a Two-Year Controlled Study

Author Affiliations

From the Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine. Dr Munetz is now with the Department of Psychiatry, University of Massachusetts, Worcester.

Arch Gen Psychiatry. 1988;45(9):797-805. doi:10.1001/archpsyc.1988.01800330021002

• Issues regarding the side effects of antipsychotic medication and the possible contribution of the environment to dose requirements led to a two-year controlled dosage study of maintenance antipsychotic medication and familial environment among recently discharged schizophrenic patients. Seventy stable patients, living in high— or low—expressed emotion (EE) households, were randomized, double blind, to receive a standard dose of fluphenazine decanoate (average, 25 mg every two weeks) or a minimal dose representing 20% of the dose prescribed (average, 3.8 mg every two weeks). No differences in relapse were observed among dose, EE, or dose and EE. Patients in the minimal dose/high-EE condition experienced more minor but aborted episodes in year 2. Side effects were fewer on the minimal dose after one year, and low-EE patients were better adjusted than high-EE patients. Over time, minimal-dose recipients were significantly more improved in their instrumental and interpersonal role performance than were standard-dose recipients.

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