The goals of the proposed study are to test whether it is possible 1) to maximize the benefits and reduce the risks of maintenance drug treatment for schizophrenia by using reduced dose strategies; 2) to employ a family management intervention to further reduce the risk of relapse, and improve social and intrafamilial functioning. The proposed study will be part of a collaborative project sponsored by the National Institute of Mental Health. One hundred ten patients will enter the study over a 2 1/2 year period, each treated for two years. Patients will be randomly assigned to one of the following antipsychotic drug treatments: Continuous low dose (fluphenazine decanoate (FD) 2.5 to 10 mg. every 3 weeks); continuous standard dose (FD 12.5 to 50 mg. every 3 weeks); discrete targeted early intervention (placebo FD 1/2 to 2 cc q 3 weeks). Each patient will also be randomly assigned to either an applied or supportive family management condition. For patients in all groups, episodes of symptom exacerbation will be treated openly with either haloperidol or FD, in addition to the """"""""blind"""""""" study medication, without breaking the blind. Once the episode is resolved, patients will continue on study treatment only. Patients assigned to applied family management will receive individual family sessions according to a predetermined schedule for the first year. Families of all patients will attend a general education workshop and have the opportunity to attend monthly group meetings throughout the two year period. Outcome measures will include relapse rates, measures of psychopathology, social functioning and side effects.
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