A comparison is made of the relative efficacy of two pharmacologic strategies in the outpatient treatment of schizophrenics recently experiencing a psychotic episode. In the first treatment approach, referred to as targeted neuroleptics, patients receive neuroleptics only when required to prevent or treat an emerging psychotic episode, suggested by the appearance of prodromal or early psychotic symptoms. In the second treatment approach patients are maintained on neuroleptics. It is hypothesized that the targeted approach results in a considerably reduced cumulative exposure to neuroleptics without showing a disadvantage in terms of hospitalization or extent of psychotic symptoms. The results of thus hypothesis demonstrates the efficacy of a pharmacological strategy presumed less likely to cause such serious side effects as tardive dyskinesia than maintenance neuroleptic treatment. Another hypothesis is that targeted neuroleptics result in a superior outcome compared to maintenance, neuroleptics in terms of deficit symptomatology, socialization, productive work, and quality of life. Patients are between the age of 18 and 50 years of age. Neuroleptics administered include haloperidol, chlorpromazine, thioridazine, and fluphenazine.
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