Targeted maintenance treatment in schizophrenia - Issues and recommendations

The development of targeted maintenance treatment with antipsychotics arose out of the recognition that, despite its efficacy for preventing relapses of schizophrenia, standard maintenance treatment was associated with a number of actual and potential disadvantages. Targeted treatment was designed to circumvent these disadvantages by decreasing total antipsychotic exposure while maintaining the prophylactic benefit of standard maintenance treatment. Targeted treatment has been shown to be effective in reducing total antipsychotic exposure and may be effective in reducing negative symptoms. However, its use is associated with an increase in relapse and hospitalisation rates. These increased rates limit the recommended use of the targeted approach to selected patient populations.