Search

Neuroleptic agents by providing symptoms remission allow community physicians to treat the schizophrenic patient in all phases of the illness. The questions of the safety and efficacy of high dose neuroleptic therapy in subjects resistant to standard dose or requiring rapid symptom remission are frequently debated. Definitive research is, however, lacking. The author concludes, after reviewing available literature, that high dose treatment is indicated for some patients. In general, the incidence of adverse effects are dose related. The decision to administer high dose medication should weigh the added risk against the potential merit of treatment.

Numerous factors are involved in determining the efficacy of tricyclic antidepressant agents in the treatment of depression. The list includes diagnosis and patient selection; pharmacodynamics, bioavailability and tissue sensitivity; natural history; placebo response, nonspecific factors; compliance and adverse effects; the effects of concurrent life events, illness and treatment, and the bias in evaluating the outcome of treatment. Physicians should be aware of the factors that influence clinical response so they can maximize therapeutic effects and utilize the agents properly.