Experiences of long‐term treatment with remoxipride: efficacy and tolerability

Abstract

An international clinical trial programme was undertaken to evaluate the clinical safety and tolerability of remoxipride during a 12 month long‐term study and to evaluate safety, tolerability and efficacy of remoxipride for up to 6 months in a double‐blind comparison with haloperidol. A total of 145 patients were treated with remoxipride for at least 12 months. In the double‐blind evaluation 106 patients on remoxipride and 50 on haloperidol were included. The doses of remoxipride ranged between 90–600 mg daily and of haloperidol between 5–45 mg daily. The therapeutic efficacy of remoxipride obtained in short‐term studies was maintained during long‐term treatment in most patients and was similar to that of haloperidol. Remoxipride had a clear cut advantage concerning extrapyramidal symptoms and anticholinergic drugs were needed less frequently with remoxipride than with haloperidol. The tolerability and safety showed no clinically significant differences compared to the data from short‐term studies. This indicates that remoxipride can be used safely and with maintained efficacy for long‐term treatment.

Prefrontal cortical dopamine systems and the elaboration of functional corticostriatal circuits: implications for schizophrenia and Parkinson's disease

“…Clozapine is the atypical APD, which does not appear to have EPS liability and targets negative as well as positive symptoms (for review, see Deutch et al, 1991 b). Remoxipride, a new putative APD that binds to D 2 DA receptors and the sigma site (Ogren etal., 1984(Ogren etal., , 1990, is a therapeutically effective agent (Ahlfors et al, 1990;Pflug et al, 1990;Lewander et al, 1990), that has very low EPS liability (Walinder and Holm, 1990); two controlled comparison studies have indicated that remoxipride has less or comparable EPS liability than thioridazine (McReadie et al, 1990;Phanjoo and Link, 1990). Preliminary data suggest that remoxipride may target negative as well as positive symptoms (Lewander etal., 1990), but this suggestion awaits confirmation.…”

Are There Dissociable Roles of the Mesostriatal and Mesolimbocortical Dopamine Systems on Temporal Information Processing in Humans?

“…akathisia, or tardive dyskinesia, are mediated. This is the reason why haloperidol, like most typical neurolep tics, causes unwanted motor side effects whereas atypical neuroleptics have a low potential for extrapyramidal symptoms [46,57,58]. While the antipsychotic effect of neuroleptics, whether typical or atypical, appears to de pend on their common ability to block D2 receptors in the mesolimbocortical DA system [59,60], the differential effects on time perception performance seen with halo pcridol, on the one hand, and sulpiride and remoxipride on the other, suggest that the pharmacologic property to modulate the internal timing mechanism is more likely to depend on D2 receptor mediated DA antagonistic effects on the basal ganglia rather than on D2 receptor activity in the mesolimbocortical DA system.…”

Atypical antipsychotic drugs in the treatment of manic syndromes in patients with HIV-1 infection

“…The main advantage of remoxipride over other drugs such as haloperidol or chlorpromazine is its relative lack of extrapyramidal (akathisia, parkinsonism and acute dystonias), autonomic and endocrine side effects (hyperprolactinaemia) (Lewander, Westerbergh and Morrison, 1990;Walinder and Holm, 1990). It also has the advantage of a slow release preparation, allowing once a day administration and less sedation (Lewander, Westerbergh and Morrison, 1990), which is often desirable for maintenance therapy.…”

“…Compared with standard antipsychotic drugs, it is a selective dopamine D2 receptor antagonist, with preferential affinity for extrastriatal receptors. It has antipsychotic efficacy comparable to haloperidol in both acute and chronic psychoses (Lewander, Westerbergh and Morrison, 1990;Walinder and Holm, 1990). …”