The International Journal of Neuropsychopharmacology

Trends and Perspectives

Treatment of schizophrenia in low-income countries

Robin A. Emsley a1c1, Pieter P. Oosthuizen a1, Andre F. Joubert a1, Susan M. Hawkridge a1 and Dan J. Stein a1
a1 Department of Psychiatry, University of Stellenbosch, South Africa


The introduction of the novel antipsychotics has had a major impact upon the treatment of schizophrenia. However, the greater acquisition costs of these drugs puts them beyond the reach of large sectors of the world's population. Consequently, the gap between the levels of care in high-income and low-income countries is likely to widen even further. Co-ordinated global action is necessary to ensure greater accessibility of these drugs. Cost-effectiveness studies in low-income countries need to be undertaken. The considerable evidence for improved safety and efficacy of low-dose compared to high-dose classical antipsychotics offers an alternative that could be implemented immediately in low-income countries.

(Received May 20 1999)
(Reviewed July 4 1999)
(Revised August 2 1999)
(Accepted August 4 1999)

Key Words: Schizophrenia; low-income countries; novel antipsychotics; low-dose classical antipsychotics.

c1 Address for correspondence: Dr R. A. Emsley, Department of Psychiatry, University of Stellenbosch, PO Box 19063, Tygerberg 7505, South Africa. Tel.: 27 21 9389227 Fax: 27 21 9336159 E-mail:

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