clopenthixol-decanoate and Basal-Ganglia-Diseases

Twenty-six patients diagnosed as chronic schizophrenics were given injections of zuclopenthixol decanoate (cis(Z)-clopenthixol decanoate) 200 mg every 3 weeks for at least 6 months. Before treatment and on each day of injection the patients' mental state was assessed by Brief Psychiatric Rating Scale (BPRS), 18 items. A registration of side effects and basal laboratory data was also performed. Blood samples were drawn on each day of injection before injection and 3-7 days after injection (time of maximum concentration). Neuroleptic activity, which was considered equivalent to the concentration of zuclopenthixol, was determined in serum by radio-receptor assay (RRA). Based on amelioration scores greater than or equal to 50% on the BPRS, 15 patients were characterized as responders and 11 as non-responders. The responder group showed a statistically significant reduction in BPRS score, whereas this was not the case for the non-responders. Apart from a few patients, the serum concentrations showed a low intra-individual variation, but a relatively high inter-individual variation. The responder group had a significantly higher mean pre-injection concentration than the non-responder group, whereas no significant difference was found in day 3-7 concentrations. The fluctuation of the serum concentration expressed as the ratio between maximum (days 3-7) and minimum (pre-inj.) was found to be significantly lower for responders than for non-responders. Thus although the present study did not demonstrate a clear relationship between serum level and clinical effect, it indicates that the best antipsychotic effect is obtained with a serum concentration which fluctuates only slightly (the ratio max/min concentration not exceeding 2.1).

Topics: Adult; Basal Ganglia Diseases; Brief Psychiatric Rating Scale; Clopenthixol; Female; Humans; Male; Middle Aged; Schizophrenia; Thioxanthenes

Twenty-three chronic schizophrenic patients were followed-up over periods up to 5 years (1978-1983) while receiving treatment with depot injections of clopenthixol decanoate in doses ranging from 100 to 600 mg every 2 to 4 weeks. The highest single dose given was 1600 mg. Improvement in psychotic symptoms occurred progressively over the 5 years, with reduction in mean overall symptom score for schizophrenia from 7.43 to 0.88. Mean side-effects scores decreased over the same period from 2.0 to 0.5. After 5 years, 10 patients were still maintained on clopenthixol decanoate. Although during the first 2 months there was little improvement in 'negative' or 'loss' symptoms, improvement was similar in 'positive' and 'negative' symptoms after 5 years. Clopenthixol decanoate appeared to have a better calming effect than that encountered with flupenthixol decanoate. At higher doses, it caused drowsiness and subdued hostility and aggression.

Topics: Adult; Antipsychotic Agents; Basal Ganglia Diseases; Chronic Disease; Clopenthixol; Female; Follow-Up Studies; Humans; Male; Middle Aged; Schizophrenia; Thioxanthenes