Pattern of intervention

A further question is whether it is better to support long-term remission via a continuous regimen of administration or whether equal benefits can accrue from interventions targeted on early relapse, identified in prodromal symptomatology. The latter has strong intuitive appeal, especially to patients, but the trial evidence is, alas, not encouraging. None of the controlled studies to investigate the issue found advantage in targeted intervention, and in a meta-analysis of published data, Davis et al. (58> calculated that while relapse rates in those continuously treated were 25 per cent, the corresponding figure for those on targeted intervention was 50 per cent (p < 1 * 10-20). While this approach may have merit in carefully selected individuals, it cannot be recommended as a routine strategy. A further potential caution to the use of intermittent treatment regimens is the increasing concern that this pattern of drug utilization may increase the risk of tardive dyskinesia. (5)

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