Relation of plasma fluphenazine levels to treatment response and extrapyramidal side effects in first-episode schizophrenic patients.
OBJECTIVE
The aim of this study was to determine the relation between plasma fluphenazine levels and clinical response in first-episode schizophrenic patients.


METHODS
Data from 36 first-episode schizophrenic or schizoaffective inpatients diagnosed according to the Research Diagnostic Criteria were evaluated. The patients received open, standardized treatment with fluphenazine, 20 mg/day, for at least 4 weeks. Psychopathology was assessed biweekly, and plasma fluphenazine levels were ascertained weekly. Patients were classified as responders or nonresponders, and correlations between their neuroleptic levels and ratings of psychopathologic and extrapyramidal symptoms were computed.


RESULTS
Plasma fluphenazine levels for weeks 1 through 4 were significantly correlated with each other but were not correlated with age, gender, diagnosis, or race. Mean neuroleptic levels (weeks 3 and 4) were not different between responders and nonresponders and were not correlated with measures of psychopathology or extrapyramidal symptoms.


CONCLUSIONS
These results do not indicate an association between plasma fluphenazine levels and response to treatment or extrapyramidal side effects in first-episode schizophrenia. The disparity between the results of this study and those of previous studies may be due to methodological differences or to a biologically based difference between first-episode and chronic patients.
Koreen
A R
AR
Hillside Hospital Division of Long Island Jewish Medical Center, Albert Einstein College of Medicine, Glen Oaks, NY 11004.
Lieberman
J
J
Alvir
J
J
Chakos
M
M
Loebel
A
A
Cooper
T
T
Kane
J
J
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D001480:Basal Ganglia Diseases / Q000139:chemically induced*; D002908:Chronic Disease; D004334:Drug Administration Schedule; D005260:Female; D005476:Fluphenazine / Q000009:adverse effects / Q000097:blood* / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000097:blood / Q000188:drug therapy; D044469:Racial Groups; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy*; D012737:Sex Factors; D016896:Treatment Outcome
D005476:Fluphenazine