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A question of time for neuroleptics.

A question of time for neuroleptics

Psychiatrists have prescribed antipsychotic drugs, also known as neuroleptics, for more than 35 years. Yet an extensive literature search performed by Paul E. Keck Jr. of McLean Hospital in Belmont, Mass., and his co-workers yields a striking finding: No clear evidence exists on how long it takes the powerful drugs, which can cause severe movement disorders with prolonged use, to begin to ease psychotic symptoms.

The researchers found only five controlled studies since 1960 that examine neuroleptic effects over time with people whose psychotic symptoms flare up for short periods, usually lasting no more than one month. Shorter studies charted moderate improvement within hours or days, while longer studies observed little change in the first few days and marked improvement only after several weeks of treatment, the researchers report in the October AMERICAN JOURNAL OF PSYCHIATRY. But placebo pills were nearly as effective as neuroleptics in the early stages of both shorter and longer studies. And sedatives such as Valium worked as well as neuroleptics in the initial stages of treatment.

Experimeter and patient expectations about the time it takes neuroleptics to work may have contributed to the contrasting findings of shorter and longer studies, according to Keck and his colleagues.

Little is known about the time it typically takes for neuroleptics to exert their effects on people with long-lasting psychotic symptoms, the scientists add.
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Publication:Science News
Date:Nov 4, 1989
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