Long-term Antipsychotic Treatment: Effective and Often Necessary, with Caveats

Acknowledgments: This piece emerged in the course of discussions with Drs. Allen Frances, E. Fuller Torrey, Bernard Carroll and Joseph Pierre, for whose assistance and contributions to the field I am most appreciative. This essay, however, represents my own synthesis of the data.




3 Wunderink L1, Nieboer RM, Wiersma D, Sytema S, Nienhuis FJ.Recovery in remitted first-episode psychosis at 7 years of follow-up of an early dose reduction/discontinuation or maintenance treatment strategy: long-term follow-up of a 2-year randomized clinical trial. JAMA Psychiatry. 2013 Sep;70(9):913-20. doi: 10.1001/jamapsychiatry.2013.19.

4 Mayoral-van Son et al, Clinical outcome after antipsychotic treatment discontinuation in functionally recovered first-episode nonaffective psychosis individuals: a 3-year naturalistic follow-up study. J Clin Psychiatry. 2015 Dec 8. [Epub ahead of print]

5 Harrow M1, Jobe TH1, Faull RN1. Does treatment of schizophrenia with antipsychotic medications eliminate or reduce psychosis? A 20-year multi-follow-up study. Psychol Med. 2014 Oct;44(14):3007-16. doi: 10.1017/S0033291714000610. Epub 2014 Mar 24.

6 Sohler N, Adams BG, Barnes DM, Cohen GH, Prins SJ, Schwartz S. Weighing the Evidence for Harm From Long-Term Treatment With Antipsychotic Medications: A Systematic Review. Am J Orthopsychiatry. 2015 Dec 14. [Epub ahead of print]

7 Leucht S, Tardy M, Komossa K, Heres S, Kissling W, Davis JM. Maintenance treatment withantipsychotic drugs for schizophrenia.Cochrane Database Syst Rev. 2012 May 16;5:CD008016. doi: 10.1002/14651858.CD008016.pub2. ?term=Cochrane+Database+Syst+Rev.+2012+May+16%3B5%3ACD008016.+doi%3A+10.1002%2F14651858.CD008016.pub2.

8 Ran M-S et al, Different outcomes of never-treated and treated patients with schizophrenia: 14-year follow-up study in rural China. The British Journal of Psychiatry (2015) 207, 495–500. doi: 10.1192/bjp.bp.114.157685 /?term=Different+outcomes+of+never-treated+and+treated+patients+with+schizophrenia%3A+14-year+follow-up+study+in+rural+China

9 Venkatasubramanian G. Neuroanatomical correlates of psychopathology in antipsychotic-naïve schizophrenia. Indian J Psychiatry. 2010 Jan;52(1):28-36. doi: 10.4103/0019-5545.58892.

10 Lesh TA, Tanase C, Geib BR, Niendam TA, Yoon JH, Minzenberg MJ, Ragland JD, Solomon M, Carter CS. A multimodal analysis of antipsychotic effects on brain structure and function in first-episode schizophrenia. JAMA Psychiatry. 2015 Mar;72(3):226-34. doi: 10.1001/jamapsychiatry.2014.2178.

11 Gellad WF, Aspinall SL, Handler SM, Stone RA, Castle N, Semla TP, Good CB, Fine MJ, Dysken M, Hanlon JT. Use of antipsychotics among older residents in VA nursing homes.
Med Care. 2012 Nov;50(11):954-60. doi: 10.1097/MLR.0b013e31825fb21d.

12 Tiihonen J, Mittendorfer-Rutz, E, Torniainen M., Alexanderson K, Tanskanen A. Mortality and Cumulative Exposure to Antipsychotics, Antidepressants, and Benzodiazepines in Patients With Schizophrenia: An Observational Follow-Up Study. AJP

For Further Reading:
Pies R: The Bogus “Epidemic” of Mental Illness in the US.

Pills photo available from Shutterstock

Long-term Antipsychotic Treatment: Effective and Often Necessary, with Caveats

This article originally appeared in:

Psychiatric Times

It is reprinted here with permission.


APA Reference
Pies, R. (2016). Long-term Antipsychotic Treatment: Effective and Often Necessary, with Caveats. Psych Central. Retrieved on June 27, 2019, from


Scientifically Reviewed
Last updated: 27 Feb 2016
Last reviewed: By John M. Grohol, Psy.D. on 27 Feb 2016
Published on All rights reserved.