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[Natural evolution of paranoid schizophrenia treated consecutively with 4 different neuroleptics].

Ms M is a young female patient (born 1968) with paranoid schizophrenia. The first acute psychotic episode, which involved marked delirium, was treated with an atypical antipsychotic agent. During the next year, renewed hospitalisation and treatment with two other antipsychotics resulted only in partial improvement, and troublesome adverse effects were noted. Amelioration of all symptoms, both psychotic and debilitating, was finally obtained through prescription of a third atypical antipsychotic with which the patient was highly satisfied. We examine the value of first-line treatment of schizophrenia with atypical antipsychotics as of the first acute episodes of acute delirium in the light of current data in the literature.