Prodromal symptoms and early intervention in schizophrenia

Background Studies of schizophrenic outpatients taken off maintenance medication show that early intervention (giving antipsychotic medication only when prodromal symptoms appear) is not as effective in relapse prevention as maintenance medication. However, there have been no controlled studies evaluating the effectiveness of early intervention (increasing antipsychotic medication when prodromal symptoms appear) for outpatients maintained on standard doses of antipsychotic medication. Method Eighty-two outpatients with schizophrenia maintained on antipsychotic medication were randomly assigned to receive either early intervention treatment (experimental) or treatment as usual with no emphasis on early intervention (control) and were followed over eighteen months. Results For patients who complied at least minimally with maintenance antipsychotic medication, early intervention was effective with fewer relapses and rehospitalizations and fewer total hospital days compared to the control group. Conclusions An early intervention approach can reduce relapse and rehospitalization rates in schizophrenic outpatients who are compliant with maintenance medication.