[Repercussions of the withdrawal of thioridazine].
BACKGROUND
As a consequence of the withdrawal of thioridazine from the market, patients who have been treated with this drug require a new therapeutic approach. We have observed patients who require admission to acute unit due to decompensation resulting from the withdrawal of thioridazine who present a difficult management of therapeutic regime. The clinical characteristics and drug treatment needed to stabilize the patient are described.


RESULTS
The sample obtained in our unit included 15 patients with a mean of 20 years of stability prior to withdrawal of thioridazine. This represents 6% of all the patients treated with thioridazine in 2005 in our health care area. They had a common psychopathological profile: affective pattern in addition to the psychotic symptomatology with predominance of emotional lability and hypomaniac tendency which is difficult to control pharmacologically. Clinical stabilization was obtained in 27 % of patients by means of piperazine phenothiazines in monotherapy. An association with mood stabilizer and/or an atypical antipsychotic in 60 % of patients was needed. In 40 % we prescribed a mood stabilizer to manage affective instability and 27% responded to electroconvulsive therapy (ECT) treatment, which is indicated as a second option due to resistance to pharmacological treatment and/or presenting a serious condition.


CONCLUSIONS
We propose starting treatment with a group of piperazine phenothiazines, evaluating the introducing of mood stabilizers and/or ECT in each case. There have been 33% re-admissions, 40% of which required medium/ long-term stay centers and one of which committed suicide. We demonstrate a high cost in terms of care, economic resources and of quality of life (autonomy, social skills and cognitive level) in our sample as a result of Meleril (thioridazine) withdrawal of the market.
Buj Alvarez
I
I
Departamento de Psiquiatría, Hospital de Santa María, Lleida.
Pifarré Paredero
J
J
Idini
E
E
Puigdevall Ruestes
M
M
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects*; D004334:Drug Administration Schedule; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000188:drug therapy*; D013375:Substance Withdrawal Syndrome / Q000209:etiology*; D013881:Thioridazine / Q000009:adverse effects*
D014150:Antipsychotic Agents; D013881:Thioridazine