benztropine and Affective-Disorders--Psychotic

Adjunctive imipramine has been found to be useful in the treatment of a substantial number of patients with syndromally defined post-psychotic depressions. This paper examines the clinical effects of the combined anticholinergic activity of imipramine, when added to ongoing fluphenazine decanoate/benztropine treatment, in such patients. Little additional anticholinergic impact of the imipramine was observable beyond that already attributable to the benztropine, and no significant relationships were found between a clinical measure of peripheral anticholinergic activity and either global clinical outcome or antidepressive efficacy. This paper also reports on the concentrations of imipramine and its metabolites in plasma under the conditions of this therapeutic trial. The changes in relative concentrations of imipramine and metabolites with time were consistent with the concept that fluphenazine competes with tricyclic metabolism. The relationship of plasma imipramine and desipramine to clinical improvement in this group of secondary depressions did not parallel previously reported relationships of these antidepressant molecules to clinical outcome in primary depressions.

Topics: Adult; Affective Disorders, Psychotic; Benztropine; Clinical Trials as Topic; Drug Interactions; Fluphenazine; Humans; Imipramine; Middle Aged; Schizophrenia; Time Factors; Tropanes

The frequency of extrapyramidal symptoms (EPS) attributed to chlorpromazine among 86 patients who received benztropine for the prevention of EPS (9.3%) was similar to that of the 568 patients who received chlorpromazine alone (10.6%). The data in this small sample indicated that the prophylactic use of benztropine had no effect in reducing the rate of EPS.

Topics: Adult; Affective Disorders, Psychotic; Basal Ganglia Diseases; Benztropine; Chlorpromazine; Drug Therapy, Combination; Female; Humans; Male; Personality Disorders; Schizophrenia; Tropanes