The pharmacological treatment for
paranoid schizophrenia is based on
antipsychotic drugs. Their actions is only suspensive but not curative. In 1980 Crow proposed a division of
schizophrenia in two major syndromes, type 1 being characterized by prominent positive symptoms. Andreasen in 1982 suggested similar criteria for positive subtype. Many others have described
schizophrenia subtypes over the years. The
paranoid schizophrenia criteria are very close to Crow's type 1 criteria. Since
chlorpromazine was synthetized in France in 1952, the French speaking psychiatrists have classified
neuroleptics according to their therapeutic efficacy and their side effects. So Deniker and Ginestet categorized
neuroleptics on the basis of their behavioural efficacy and distinguished
sedative neuroleptics from anti-delusional
neuroleptics and anti-autistic
neuroleptics. French psychiatrists consider that there are qualitative differences between various
neuroleptics. In USA, equivalent doses are established with
chlorpromazine for many
neuroleptic drugs, but equivalency doses are considered as crude at best by some, such as J.M. Kane. The typical
neuroleptic treatment is reviewed: target symptoms, choice of
drug, dosage, route of administration, combined medications, predictive clinical and
biological parameters of response,
duration of treatment. Failure to response to
neuroleptic treatment is not uncommon. Some strategies are detailed for the treatment-resistant patients. Combination of
neuroleptics like
haloperidol +
thioproperazine or
haloperidol +
trifluoperazine may be useful.(ABSTRACT TRUNCATED AT 250 WORDS)