Observations on the Dose Regime of Fluphenazine Decanoate in Maintenance Therapy of Schizophrenia

1975 ◽  
Vol 126 (5) ◽  
pp. 457-461 ◽  
Author(s):  
D. A. W. Johnson
Keyword(s):  
Side Effects ◽  
Maintenance Therapy ◽  
Clinical Importance ◽  
Fluphenazine Decanoate ◽  
Dose Regime ◽  
Schizophrenic Patients

SummaryAn analysis of the drug regimes prescribed to two separate groups of unselected schizophrenic patients indicates certain trends of clinical importance. The results demonstrate a need for the adoption of a personalized dose regime. The scatter of dose regimes found effective is too great to recommend a standardized approach to the prescription of L.A.P. injections.Two other results of particular significance are that the dose of drug required to control symptoms can be gradually reduced in nearly half of patients, and that helpful trends in prescribing were identified that will help the clinician to abolish side-effects.

scholarly journals Adherence to depot versus oral antipsychotic medication in schizophrenic patients during the long-term therapy

2013 ◽  
Vol 70 (3) ◽  
pp. 267-273 ◽  
Author(s):  
Zana Stankovic ◽  
Tatjana Ille
Keyword(s):  
Medication Adherence ◽  
Maintenance Therapy ◽  
Atypical Antipsychotics ◽  
Categorical Variables ◽  
Medical Adherence ◽  
Fluphenazine Decanoate ◽  
Illness Duration ◽  
Depot Antipsychotic ◽  
Schizophrenic Patients ◽  
Oral Antipsychotic

Background/Aim. There is a high rate of schizophrenic patients who do not adhere to their prescribed therapy, despite the implementation of antipsychotic long-acting injections and the introduction of atypical antipsychotics. The aim of this study was to investigate the differences in sociodemographic, clinical and medication adherence variables between the two groups of schizophrenic patients on maintenance therapy with depot antipsychotic fluphenazine decanoate and oral antipsychotics only as well as a correlation between the medication adherence and other examined variables. Methods. A total of 56 patients of both genders, aged < 60 years, with the diagnosis of schizophrenia (F20) (ICD-10, 1992) clinically stable for at least 6 months were introduced in this cross-sectional study. The patients from the depot group (n = 19) were on classical depot antipsychotic fluphenazine decanoate administering intramuscularly every 4 weeks (with or without oral antipsychotic augmentation) and the patients from the oral group (n = 37) were on oral therapy alone with classical or atypical antipsychotics, either as monotherapy or combined. The Positive and Negative Syndrome Scale (PANSS) was used to assess symptom severity. Item G12 of the PANSS was used to assess insight into the illness. The patients completed the Medical Adherence Rating Scale (MARS) was used to assess adherence to the therapy. A higher MARS score indicates behavior [Medical Adherence Questionnaire (MAQ subscale)] and attitudes toward medication [Drug Attitude Inventory (DAI subscale)] that are more consistent with treatment adherence. The exclusion criteria were determined. The Pearson's ?2 test was used to compare categorical variables, Student's t-test to compare continuous variables and Pearson's correlation to test the correlation significance; p = 0.05. Results. Significant betweengroup differences in age, illness duration, chlorpromazine equivalents, PANSS score and DAI subscore were found. Item G12 of the PANSS subscore and MARS score correlated significantly negatively. A significant positive correlation between receiving depot antipsychotic and DAI subscore as well as between illness duration and both DAI subscore and MARS score were also found. Conclusion. Schizophrenic patients on classical depot antipsychotic maintenance therapy might present subpopulation of patients with significantly longer illness duration, more favorable medication attitude and outcome in relation to those on oral antipsychotics alone.

A Double-Blind Comparison of Fluspirilene and Fluphenazine Decanoate in Schizophrenia

1982 ◽  
Vol 27 (7) ◽  
pp. 593-596 ◽  
Author(s):  
N. Russell ◽  
J. Landmark ◽  
H. Merskey ◽  
T. Turpin
Keyword(s):  
Side Effects ◽  
Double Blind ◽  
Fluphenazine Decanoate ◽  
New Drug ◽  
Schizophrenic Patients ◽  
Blind Comparison

A double-blind comparison of fluspirilene and fluphenazine decanoate in 28 schizophrenic patients over six months showed equal improvement and the same incidence of side-effects in each group of patients. It would be expected from the literature that a better ratio of therapeutic to side-effects would appear with fluspirilene than with fluphenazine. The absence of such an effect in this study may be attributable to an initial lack of familiarity by the investigators with the use of fluspirilene, indicating an important potential variable in the comparison of a new drug with an established one.

Plasma Levels of Fluphenazine in Patients Receiving Fluphenazine Decanoate Relationship to Clinical Response

1991 ◽  
Vol 158 (5) ◽  
pp. 658-665 ◽  
Author(s):  
Stephen R. Marder ◽  
Kamal K. Midha ◽  
Theodore Van Putten ◽  
Manickam Aravagiri ◽  
Edward M. Hawes ◽  
...  
Keyword(s):  
Steady State ◽  
Side Effects ◽  
Plasma Levels ◽  
Fluphenazine Decanoate ◽  
Oral Supplementation ◽  
Significant Relationships ◽  
Increased Risk ◽  
Schizophrenic Patients ◽  
To Receive ◽  
Steady State Plasma Level

The levels of fluphenazine and fluphenazine sulphoxide in schizophrenic patients who were randomly assigned to receive either 5 mg or 25 mg of fluphenazine decanoate every two weeks were monitored. Patients treated with 25 mg of fluphenazine decanoate required three months to reach a steady-state plasma level, indicating that those patients who are being converted from oral to depot fluphenazine should continue to receive oral supplementation during the first three months of treatment with fluphenazine decanoate. Plasma levels of fluphenazine sulphoxide were lower than levels of fluphenazine. At six and nine months following randomisation, there was a statistically significant relationship between lower fluphenazine plasma levels and an increased risk of psychotic exacerbations. A relatively weak relationship was found between fluphenazine plasma levels and akinesia, but non-significant relationships between fluphenazine levels and other neurological side-effects including akathisia, retardation, and tardive dyskinesia. Monitoring the plasma levels may be helpful to clinicians who are attempting to treat stabilised patients with the lowest effective dose of fluphenazine decanoate.

Sulpiride and Haloperidol in Schizophrenia: A Double-blind Cross-over Study of Therapeutic Effect, Side Effects and Plasma Concentrations

1985 ◽  
Vol 147 (3) ◽  
pp. 283-288 ◽  
Author(s):  
Jes Gerlach ◽  
Kirsten Behnke ◽  
Jon Heltberg ◽  
Ebbe Munk-Andersen ◽  
Henrik Nielsen
Keyword(s):  
Side Effects ◽  
Plasma Concentrations ◽  
Clinical Effects ◽  
Median Dose ◽  
Double Blind ◽  
Day Range ◽  
Daily Dose ◽  
Schizophrenic Patients ◽  
High Doses ◽  
Therapeutic Profile

SummaryIn a double-blind cross-over trial, 20 chronic schizophrenic patients were treated with sulpiride and haloperidol in two 12-week periods. The final median dose of sulpiride was 2000 mg/day (range 800–3200) and of haloperidol 12 mg/day (range 6–24). Sulpiride had an antipsychotic effect and therapeutic profile not significantly different from that of haloperidol. In spite of the high doses of sulpiride, extrapyramidal side-effects were seen less frequently during the first four weeks of the sulpiride period than during the corresponding haloperidol period (P < 0.05), whereas autonomic side-effects were equally rare for both drugs. A positive correlation was found between daily dose and plasma concentration of both sulpiride (P < 0.001) and haloperidol (P < 0.05), but no correlation could be established between clinical effects and plasma levels of either neuroleptic.

The Expectation of Outcome from Maintenance Therapy in Chronic Schizophrenic Patients

1976 ◽  
Vol 128 (3) ◽  
pp. 246-250 ◽  
Author(s):  
D. A. W. Johnson
Keyword(s):  
Maintenance Therapy ◽  
Patient Population ◽  
Significant Proportion ◽  
Community Services ◽  
Neuroleptic Drugs ◽  
Follow Up Study ◽  
High Incidence ◽  
Schizophrenic Patients ◽  
Long Acting

SummaryThe results from a prospective follow-up study of a group of schizophrenic patients suggest that a significant proportion (41 per cent) are likely to relapse during a two-year period despite the prescription of long-acting injectable neuroleptic drugs. Some will relapse because of a failure of the regime, but others (32–37 per cent) because the pharmacological protection of these drugs would appear to be less effective in certain patients. Even with the major advantages of the long-acting injectable neuroleptics over oral medication, the schizophrenic patient population remains a group with a high incidence of psychiatric and social morbidity which continues to require the full resources of both the hospital and community services.

Electroconvulsive therapy in schizophrenia – where do we stand?

2016 ◽  
Vol 33 (S1) ◽  
pp. s262-s263
Author(s):  
J. Silva ◽  
J. Mota ◽  
P. Azevedo
Keyword(s):  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Severe Depression ◽  
Psychotic Symptoms ◽  
Drug Intolerance ◽  
Rapid Control ◽  
Practice Of Medicine ◽  
Nice Guidance ◽  
Schizophrenic Patients ◽  
Competing Interest

IntroductionElectroconvulsive therapy is currently used in the management of severe depression, long-term mania and catatonia. Regarding schizophrenia-related psychosis ECT is also an option, but the indication is restrictive to severe cases, drug intolerance or resistant ones. Lack of evidence of cost-effectiveness compared to clozapine, and side effects of ECT techniques before 2003, influenced NICE guidance to not recommend ECT in schizophrenia, but modern ECT machines and procedures are subsequent to 2003. ECT is often performed when clozapine fails to respond in monotherapy or if there is intolerance to antipsychotic side effects. ECT in combination with clozapine seems to have significant results allowing the patients to achieve rapid control of psychotic symptoms with fewer side effects, comparing with antipsychotics-association strategies.ObjectivesTo summarized the latest literature about this field and to present recent data from the Electrovulsivetherapy Unit, in Hospital de Magalhães Lemos, Portugal.AimTo explore and critically review the controversies of electroconvulsive therapy in the management of drug-resistant schizophrenia.MethodsRetrospective data of an Electroconvulsive Therapy Unit during 2006–2015 was review.Results198 ECT treatments in schizophrenic patients were performed in our unit, during 2006–2007, in a total of 647 ECT (30,6%). In 2014–2015, 945 schizophrenic patients received ECT treatment, in a total of 2149 performed ECT (43,9%).ConclusionsAlthough guidelines are crucial for the uniform practice of medicine, sometimes is important to be critical about them. The use of ECT in schizophrenia is safe and effective and further research is needed to continue to support this treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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