Large variations of plasma levels during maintenance treatment with depot neuroleptics.
BACKGROUND
Stability of neuroleptic medication has been associated with optimal clinical effect and minimal side-effects. Depot administration is assumed to yield better stability.


METHODS
Thirty patients on depot neuroleptic treatment were followed during three years with repeated measurements of plasma level and concurrent ratings of clinical symptoms and side-effects.


RESULTS
Of 120 blood samples 35 (29%) measurements were outside +/-2 s.d. measurement error (expected 5%). Perphenazine levels were more variable (46%) than haloperidol (25%) and flupenthixol (12.5%). No relationship was found between side-effect ratings and fluctuations of plasma levels.


CONCLUSIONS
Depot neuroleptic medication does not eliminate a clinically unwanted and sometimes marked variation in plasma level.
Tuninger
E
E
Department of Psychiatry, Malmõ Lund University, Sweden.
Levander
S
S
D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics*; D003692:Delayed-Action Preparations; D016903:Drug Monitoring; D005260:Female; D005475:Flupenthixol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000493:pharmacokinetics; D005500:Follow-Up Studies; D006220:Haloperidol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000493:pharmacokinetics; D006801:Humans; D007273:Injections, Intramuscular; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010546:Perphenazine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000493:pharmacokinetics; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000097:blood* / Q000188:drug therapy; D012565:Schizophrenic Psychology
D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; C007761:flupenthixol decanoate; C033563:haloperidol decanoate; D005475:Flupenthixol; D010546:Perphenazine; D006220:Haloperidol; C047342:perphenazine decanoate