Continuation treatment

The effectiveness of psychopharmacotherapy is usually manifested in the first 6 weeks, with improved sleep, regression of agitation, recovery from anxiety and delusion, and finally disappearance of the psychotic features. When there is no recovery or improvement either another antipsychotic drug should be used or the dosage of the first increased. Worsening of the symptoms, serious side-effects, or a poor response to pharmacotherapy are the main indications for electroconvulsive therapy.

If mood disorders or cyclic episodes occur, treatment with antidepressants, mood stabilizers (lithium or valproate), or an anticonvulsant drug (carbamazepine) may be indicated. Care must be taken to distinguish between a post-neuroleptic depression and the development of a (schizo)affective disorder.

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