Positiv-und Negativsymptomatik bei chronisch schizophrenen Patienten unter Erhaltungstherapie mit Flupentixol-Decanoat im 12-Monats-Verlauf

Abstract

62 chronic schizophrenics, who after a psychotic exacerbation were stabilized again, were randomized on 3 different maintenance dosages of flupentixol-decanoate and observed for 12 months. 15 (24.2%) patients had a relapse independently of the dose. 34 of the 47 patients without relapse had complete documentations of the follow-up. After 3 to 6 months there was an obvious and constant clinical improvement as assessed by various test inventories. The BPRS-scores for psychopathology, negative and positive symptoms improved significantly between 14 to 18%. There was also significant reduction of negative symptoms assessed by SANS (22%) as well in the severity of illness (CGI) and an amelioration of psychosocial functioning (GAS, Strauss-Carpenter). At the end of trial 26.4% of the patients had mild involuntary movements (AIMS), 23.5% were on antiparkinson-medication. It is concluded that there could be an indication for flupentixol-decanoate in the long term maintenance therapy especially of chronic schizophrenics with negative symptoms and problems of compliance under oral medication.

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

“…Evidence suggests that flupenthixol is very effective in treating negative symptoms of schizophrenic patients [51]. According to Gruber and Cole [52], flupenthixol is useful as an antidepressant.…”

“…When integrating clinical and basic data, the question 'which special neuroleptic treatment should be used for which subgroup of schizophrenic patients' arises. Following the paper of Tandon et al [28] and that of Schooler [36], we used risperidone, a well documented atypical medication in schizophrenia, and flupenthixol, a typical drug (D 2 receptor) with some atypical properties (5-HT 2A ), and documented not only psychopathology but also subjective quality of life and attitude towards medication [22,26,28,30,31,36,51,[53][54][55][56].…”

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

“…As several studies suggest that depot medication with flupentixol might have a positive effect on the long-term course of patients with schizophrenia (Knudsen 1985;Eberhard and Hellbom 1986;Pach et al 1998b), this may bias our results. In our study, the percentage of patients who had received at least one antipsychotic depot medication was substantially higher for flupentixol (10.1% of subgroup) and other first-generation antipsychotics (8.2% of subgroup) than for the second-generation antipsychotics (1.5% of subgroup).…”

“…In the flupentixol group, the 'ability to cope with stress', 'feel more relaxed' and the 'ability to achieve something' improved significantly more than in the risperidone group. Evidence also suggested that flupentixol is effective in treating negative symptoms (Pach et al 1998a;Philipp et al 2003;Gattaz et al 2004) and useful as an antidepressant (Gruber and Cole 1991;Budde 1992). These effects are probably based on the different receptor profile of flupentixol compared to other firstgeneration antipsychotics such as haloperidol.…”

Psychopharmakologische Langzeittherapie der Schizophrenie und die neu entwickelten Substanzen

“…In einer über 12 Monate durchgeführten Untersuchung an chronisch schizophrenen Patienten, deren Zustand sich nach einer akuten psychotischen Exazerbation wieder stabilisiert hatte, ergab sich unter 5 ± 40 mg/2 Wochen für die Scores für Negativsymptomatik der ¹Brief Psychiatric Rating Scaleª (BPRS) und der ¹Scale for Assessment of Negative Symptomsª (SANS) jeweils ein signifikanter Rückgang um bis zu 22 % des Ausgangswertes [14]. In diesem Zusammenhang wird für Flupentixol aufgrund seiner hohen Affinität zu 5-HT 2A -(und 5-HT 2C -) Rezeptoren und Dopamin-D 1 -Re- [39].…”