To determine the effectiveness of high dose neuroleptic treatment (more than 1500 equivalents of chlorpromazine) in chronic and therapy resistant schizophrenic patients all relevant investigations and three reviews were studied.

In four out of seventeen studies (very) high dose treatments were superior to standard doses of 300 to 600 equivalents of CPZ. In five other studies high doses were preferred in some respects. Complete remissions were rare and only found in some retrospective non-blind controlled studies. Good results reported by one author in certain subgroups were not confirmed by other authors. Only the presence of nontrue symptoms were mentioned to be conditional for response by two authors. Side-effects increased with higher dosages.

A definite recommendation on the use of high dosages neuroleptics can't be made. This doesn't mean this strategy is not indicated, but we shouldn't have too high expectations.