Research in Schizophrenia and the Discontinuation

This article, and the accompanying one by Dr. Carpenter, discuss the benefits and risks associated with taking patients with schizophrenia off medica-tions for research purposes. This article reviews the concept that at least some forms of schizophrenia are progressive. Evidence for this view is provided by studies examining the impact of early intervention with antipsychotic medications on the long-term mor-bidity of schizophrenia, as well as the few studies examining the long-term risks of discontinuing antipsychotic medications in patients with schizophre-nia. While there is evidence that early intervention improves the long-term course of the illness, it is not known whether withdrawal of antipsychotic medica-tions increases long-term morbidity. This is an area where further information is needed for clinical prac-tice and research. Schizophrenia Bulletin, 23(l):3-9,1997. There are a number of noteworthy issues surrounding the potential risks of taking schizophrenia patients off med-ications for research purposes. For example, the question of whether discontinuation of antipsychotic medications is associated with an increased risk of behaviors that could be harmful to the patient or to others is important but largely unstudied (Johnson et al. 1983). If such risks exist, the thoughtful care of patients in research settings can greatly decrease them. In fact, evidence suggests that research patients are no more likely to suffer adverse con-sequences, and at times receive greater benefits, than those treated in normal clinical settings (Cardon et al