Mechanism of the antipsychotic effect in the treatment of acute schizophrenia.
In a double-blind trial in which 45 patients with acute schizophrenia took part the alpha-isomer of flupenthixol (which blocks the dopamine receptor) was found to be significantly more effective than both beta-flupenthixol (which does not) and placebo. The drug effect was confined to the "positive" symptoms--delusions, hallucinations, and though disorder--and appeared only in the 3rd and 4th weeks of the trial. It was as great in patients with evidence of deterioration (Feighner-positive patients) as in patients without deterioration and was less in patients who had affective disturbance in addition to schizophrenia symptoms. The findings are consistent with the hypothesis that dopamine-receptor blockade is the only requirement for antipsychotic activity and suggest that the antipsychotic effect occurs in patients with typically schizophrenic illnesses but may be limited to positive symptoms.
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002746:Chlorpromazine / Q000008:administration & dosage / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D005260:Female; D005475:Flupenthixol / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D007536:Isomerism; D008297:Male; D010919:Placebos; D011954:Receptors, Dopamine / Q000187:drug effects; D012107:Research Design; D012559:Schizophrenia / Q000188:drug therapy*; D013892:Thioxanthenes / Q000494:pharmacology*
D010919:Placebos; D011954:Receptors, Dopamine; D013892:Thioxanthenes; D005475:Flupenthixol; D002746:Chlorpromazine