Rationalizing neuroleptic polypharmacy in chronic schizophrenics: effects of changing to a single depot preparation.
This study investigated the effects of transferring patients on combined depot and oral neuroleptics to a single depot preparation; a secondary objective was to assess the effects of transferring patients from one depot neuroleptic to another. It was found that, whereas transferring from one depot preparation (flupenthixol) to another (fluphenazine) had no clear disadvantage for the patients, changing over from a combined oral and depot (fluphenazine) regimen to equivalent doses of depot alone resulted in an unacceptably high rate of relapse. The reasons for this may relate to either the unique pharmacokinetics of these drugs or subtle qualitative differences between them. It is suggested that caution is necessary whenever attempts are made to rationalize polypharmacy in schizophrenic patients.
Psychiatric Research Unit, University of Manchester School of Medicine, United Kingdom.
S D
SD
Soni
G
G
Sampath
A
A
Shah
J
J
Krska
D000284:Administration, Oral; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D004409:Dyskinesia, Drug-Induced / Q000209:etiology; D005260:Female; D005475:Flupenthixol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D005476:Fluphenazine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000187:drug effects; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy*; D012565:Schizophrenic Psychology
D014150:Antipsychotic Agents; C007761:flupenthixol decanoate; D005475:Flupenthixol; C011825:fluphenazine depot; D005476:Fluphenazine