Methylphenidate challenge as a predictor of relapse in schizophrenia

Am J Psychiatry. 1984 May;141(5):633-8. doi: 10.1176/ajp.141.5.633.

Abstract

Although neuroleptics are the major treatment for schizophrenia, there are no effective measures to determine the appropriate or necessary length of neuroleptic maintenance. To test the ability of a psychostimulant challenge to predict relapse following neuroleptic withdrawal, the authors administered methylphenidate and placebo infusions to 11 stable schizophrenic outpatients who had been on a neuroleptic maintenance regimen for at least 6 months. Patients withdrawn from neuroleptics were followed until relapse. All three patients with a positive response to methylphenidate challenge relapsed in 1 to 7 weeks; one of seven negative responders relapsed at week 21. Differences in relapse rates (p = .033) and survival time (p = .005) between negative and positive responders were significant.

MeSH terms

  • Adult
  • Antipsychotic Agents / adverse effects*
  • Double-Blind Method
  • Female
  • Humans
  • Infusions, Parenteral
  • Male
  • Methylphenidate* / administration & dosage
  • Methylphenidate* / pharmacology
  • Placebos
  • Psychiatric Status Rating Scales
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / drug therapy
  • Psychotic Disorders / psychology
  • Random Allocation
  • Recurrence
  • Schizophrenia / diagnosis
  • Schizophrenia / drug therapy*
  • Schizophrenic Psychology*
  • Substance Withdrawal Syndrome / etiology*

Substances

  • Antipsychotic Agents
  • Placebos
  • Methylphenidate