Flupenthixol versus Risperidone: Subjective Quality of Life as an Important Factor for Compliance in Chronic Schizophrenic Patients

Abstract

Objective: The primary aim of this paper was to compare the effects of flupenthixol and risperidone on subjective quality of life and attitude towards medication in chronic schizophrenic patients with mainly negative symptoms. In a spectrum ranging from its typical end ‘haloperidol’ to its atypical end ‘clozapine’, flupenthixol has typical and atypical characteristics. Methods: The effects of flupenthixol versus risperidone were investigated in a multicenter, double-blind trial, whereas subjective quality of life was assessed by means of the EuroQuol-Visual Analogue Scale and the patient satisfaction questionnaire. The attitude towards medication was assessed by means of the Drug Attitude Inventory-30 (DAI-30). Results: Mean daily dose of study medication was 6.6 (SD 2.9) mg/day flupenthixol and 3.6 (SD 1.2) mg/day risperidone. Both groups showed a significant improvement regarding subjective quality of life and positive attitude towards medication. Especially the categories ‘control of their thoughts’, concentration and ‘feeling better in general’ ameliorated in both groups. In the flupenthixol group, the ‘ability to cope with stress’, ‘feel more relaxed’ and the ‘ability to achieve something’ improved significantly more than in the risperidone group. Conclusions: (1) The spectrum of schizophrenia can be treated effectively with different neuroleptic treatments. (2) Flupenthixol especially improves the ability to cope with stress, the ability to achieve something and feeling more relaxed. (3) Subjective quality of life significantly increased with no difference between the groups.

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, Part 2: Long-term treatment of schizophrenia

“…A single-blind naturalistic study in which patients were switched from FGAs to either risperidone, olanzapine or quetiapine showed significant improvement in several aspects of quality of life at 1-year follow-up (Voruganti et al 2002). No significant difference in subjective quality of life (EuroQuol-Visual Analogue Scale) could be detected in a double-blind trial comparing flupenthixol and risperidone, while the ability to cope with stress, to achieve something and to feel relaxed improved significantly more in the flupenthixol group (Hertling et al 2003).…”

Effectiveness and costs of flupentixol compared to other first- and second-generation antipsychotics in the treatment of schizophrenia

“…FGA first-generation antipsychotics, SGA second-generation antipsychotics were no significant differences between the groups concerning the improvement of negative symptoms and general psychopathology. Subjective quality of life, as an important factor for compliance in chronic schizophrenic patients, was investigated in a multi-centre, double-blind trial with 76 patients treated with flupentixol and 77 patients treated with risperidone (Hertling et al 2003). Both groups showed a significant improvement regarding subjective quality of life.…”

“…Current evidence suggests that flupentixol has first-and second-generation characteristics and probable beneficial effects in patients with predominantly negative symptoms (Kühn et al 2000;Müller et al 2002;Philipp et al 2003;Hertling et al 2003;Gattaz et al 2004). We therefore compared the effectiveness and costs of patients treated with flupentixol with other first-and second-generation antipsychotics in a real world setting using routine data from four German sickness funds (Techniker Krankenkasse, AOK Baden-Wuerttemberg, AOK Westfalen-Lippe and AOK Berlin).…”

Meet the relatives: a reintroduction to the clinical pharmacology of ‘typical’ antipsychotics (Part 2)

“…In terms of quality of life, Hertling et al (2003) found that people with schizophrenia treated with flupentixol felt subjectively more relaxed and better able to deal with stress than those on risperidone.…”