An Unusual Occurrence of Trifluoperazine-Induced Nystagmus in Persistent Hallucinatory Disorder—A Case Report

Trifluoperazine is a conventional antipsychotic whose use has been limited with the arrival of relatively new atypical antipsychotics. However, conventional antipsychotics are utilized in the management of psychiatric illnesses comorbid with metabolic disorders such as diabetes or dyslipidemia. Though trifluoperazine has been known to cause extrapyramidal symptoms, rarely ophthalmic symptoms manifest. Here, we discuss the rare occurrence of newly-emergent nystagmus in an individual with persistent hallucinatory disorder and comorbid diabetes mellitus treated with trifluoperazine.

Neurocognitive effects of atypical and conventional antipsychotic drugs in early-stage schizophrenia: a naturalistic 12-month follow-up study

IntroductionThe relative effect of the atypical antipsychotic drugs and conventional agents on neurocognition in patients with early-stage schizophrenia has not been comprehensively determined.AimsThe present study aimed to assess the cognitive effects of atypical and conventional antipsychotic drugs on neurocognition under naturalistic treatment conditions.ObjectivesIn a 12 months open-label, multicenter study, 698 patients with early-stage schizophrenia (< 5 years) were monotherapy with chlorpromazine, sulpiride, clozapine, risperidone, olanzapine, quetiapine or aripiprazole. Wechsler Memory Scale--Revised Visual Reproduction Test, Wechsler Adult Intelligence Scale Revised Digit Symbol Test and Digit-span Task Test, Trail Making Tests Part A and Part B, and Wisconsin Card Sorting Test were administered at baseline and 12 months follow-up evaluation. The primary outcome was change in a cognitive composite score after 12 months of treatment.ResultsCompared with scores at baseline, the composite cognitive test scores and individual test scores had significant improvement for all seven treatment groups at 12-month follow-up evaluation (all p-values ≤ 0.013). However, olanzapine and quetiapine provided greater improvement than that provided by chlorpromazine and sulpiride in the composite score, processing speed and executive function (all p-values ≤ 0.045).ConclusionsBoth conventional and atypical antipsychotic medication long-term maintenance treatment can benefit congitive function in patients with early-stage schizophrenia, but olanzapine and quetiapine may be superior to chlorpromazine and sulpiride in improving some areas of neurocognitive function.