Costs and Benefits of Two Doses of Fluphenazine

Marder, Stephen R.; Putten, Theodore Van; Mintz, Jim; McKenzie, Joanne E.; Lebell, M.; Faltico, G.; May, Philip R. A.

doi:10.1001/archpsyc.1983.01790220015002

Cited by 177 publications

(69 citation statements)

References 11 publications

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“…Several authors have related the onset of secondary anhedonia to the use of antipsychotic drugs [37,38]. This secondary anhedonia could be either due to the direct action of neuroleptics or to an 'akinetic depression' targeted by the drugs [39].…”

Section: Discussionmentioning

confidence: 99%

Anhedonia in the Deficit Syndrome of Schizophrenia

1999

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Previous studies have shown that anhedonia characterizes the deficit syndrome of schizophrenia. Anhedonia is also one of the main symptoms of the depressive state. The purpose of this study was to examine the relationships between anhedonia and depression in the deficit syndrome of schizophrenia. Self-evaluations of anhedonia and depression were performed by three groups of subjects (32 deficit schizophrenics, 32 major depressives, 35 healthy subjects) matched for sociodemographic variables. Deficit schizophrenics and major depressives are more anhedonic than controls, but there is no difference between the two study groups. Contrarily to what is evidenced for major depressives and for healthy subjects, the depressive symptomatology correlates with anhedonia in deficit schizophrenics. When deficit schizophrenics are dichotomized into depressed versus non-depressed patients, no difference is observed concerning anhedonia. These results suggest that anhedonia in the deficit syndrome of schizophrenia has no specificity but appears independent of coexisting depression and covaries with several characteristics of depression (retardation, cognitive distortions). Our results support the hypothesis that the deficit syndrome of schizophrenia could constitute a non-depressive mood disorder.

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Section: Discussionmentioning

confidence: 99%

Anhedonia in the Deficit Syndrome of Schizophrenia

1999

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“…Hospital. The details of the patient selection process and the study methodology are described elsewhere (Marder et al 1984). Table 1 describes the demographic characteristics of patients entered into this study.…”

Section: Methodsmentioning

confidence: 99%

“…Clinical outcome was measured at the same interval occasions when plasma levels were drawn. Rating instruments included the Brief Psychiatric Rating Scale (BPRS), the Hopkins Symptom Checklist (SCL-90R), the Involuntary Movement and Extrapyramidal Rating Scale (IMEPS), and the Subjective Extrapyramidal Rating Scale (SERS) (Marder et al 1984). To reduce the number of items in the IMEPS and SERS, a principal components analysis 481 was utilized.…”

Section: Methodsmentioning

confidence: 99%

Fluphenazine plasma levels in patients receiving low and conventional doses of fluphenazine decanoate

et al. 1986

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Plasma fluphenazine concentrations (FLU) were measured in 45 patients with schizophrenic disorders who participated in a double-blind comparison of 5 and 25 mg fluphenazine decanoate (FD). The rise in plasma level of FLU 24 h after a "test dose" was significantly correlated with steady state FLU concentration at 12 weeks (for 5 mg patients, r = 0.45, P = 0.04; for 25 mg, r = 0.78, P = 0.005). Patients who had low FLU at baseline required nearly 6 months to reach a steady state when they received 25 mg. Patients who received 5 mg and had low FLU at baseline continued to demonstrate relatively low plasma levels for the entire 1st year. Although the mean FLU at 6 months was lower for patients who relapsed during the subsequent 18 months (0.57 ng/ml for relapsers vs 1.01 ng/ml for nonrelapsers), this difference was not statistically significant. When plasma levels from both dosage groups were combined, FLU at 12 weeks correlated significantly with factor scores for akinesia (r = 0.52, P = 0.002) and BPRS cluster scores for retardation (r = 0.52, P = 0.002). These results indicate that the measurement of fluphenazine plasma levels may be useful in determining when patients treated with FD are receiving drug doses which are likely to cause discomforting side effects.

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“…For example, Baldessarini and coworkers have computed an EDso of 5 mg every 2 weeks for fluphenazine decanoate. However, the studies on which this figure is based (Rifkin et al 1977;Hogarty et al 1979;Kane et al 1983;Marder et al 1984) usually involved patients who had been well stabilized and may not be relevant for individuals who have recently recovered from an acute episode.…”

Section: Use Of Oral Supplementation During the Change To Linmentioning

confidence: 99%

Pharmacokinetics of long-acting injectable neuroleptic drugs: clinical implications

et al. 1989

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The authors review the literature regarding the pharmacokinetics of long-acting injectable neuroleptic drugs (LINS). There are important differences between LINS and oral neuroleptics that affect their pharmacokinetics. By avoiding first pass metabolism in gut and liver, LINS result in lower circulating concentrations of metabolites than are found after oral administration. In addition, LINS take more time to reach a stable steady state than their oral counterparts. The clinical significance of these pharmacokinetic properties is discussed. The authors recommend that when patients are being changed from oral neuroleptics to LINS, that this conversion be done gradually over several months.

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Costs and Benefits of Two Doses of Fluphenazine

Cited by 177 publications

References 11 publications

Anhedonia in the Deficit Syndrome of Schizophrenia

Anhedonia in the Deficit Syndrome of Schizophrenia

Fluphenazine plasma levels in patients receiving low and conventional doses of fluphenazine decanoate

Pharmacokinetics of long-acting injectable neuroleptic drugs: clinical implications

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