Prognosis In Schizophrenia - Individual-Differences In Psychological Response To A Test Dose Of Antipsychotic Drug And Their Relationship To Blood And Saliva Levels And Treatment Outcome

Plasma and saliva CPZ concentrations and their relationships to psychometric change following a single test dose of drug were studied in schizophrenic patients. There were great individual differences: in some cases performance was improved, in others it was reduced. In general, psychometric change followed CPZ plasma levels but with a definite time lag. Nevertheless, the relationship was neither simple nor direct. CPZ levels and drug effects on psychometric parameters did not proceed hand in hand: curves in individual cases may be offset or there may be no effect on one measure, even though the others change. Disappointingly, there was no significant relationship between test dose performance and the eventual outcome of a course of drug treatment. These observations imply that it is unlikely that there is a simple relationship between therapeutic change and plasma levels. We conclude from our test dose research, so far, that the most fruitful predictors of therapeutic outcome may be early plasma and saliva levels of drug, early clinical response, and the patient's initial subjective response to the drug effect.