clopenthixol-decanoate and Chronic-Disease

Zuclopenthixol decanoate (ZPT-D) and haloperidol decanoate (HAL-D) were compared in the maintenance treatment of chronic schizophrenic patients. All patients were treated with either ZPT-D or HAL-D for at least 3 months and were then randomly allocated to treatment with either ZPT-D (100-600 mg every 4 weeks) or HAL-D (38-200 mg every 4 weeks) for 9 months. Sixty-four patients entered the study. Three patients were only assessed at baseline. Four patients in the HAL-D group were withdrawn because of deterioration. One patient in the ZPT-D group committed suicide. Fifty-six patients completed the trial. The assessment programme comprised Clinical Global Impressions by psychiatrists and nurses, the Brief Psychiatric Rating Scale (BPRS), Montgomery-Asberg Depression Rating Scale (MADRS), UKU Side Effect Scale and Simpson-Angus Scale, Ratings were made at baseline and after 12, 24 and 36 weeks of treatment. The severity of illness scores remained almost constant. The only between-group difference was recorded at month 6 in favour of ZPT-D. The BPRS total scores were reduced significantly in both groups with no between-group differences. The depression scores on the MADRS were very low. Both treatments caused few and mild side effects according to the UKU Side Effect Scale and the Simpson-Angus scale, and there were no significant differences between the groups. Both ZPT-D and HAL-D seem to be effective in the maintenance treatment of chronic schizophrenic patients and cause few side effects. The injections of ZPT-D and HAL-D can be given at 4-week intervals.

Topics: Adult; Antipsychotic Agents; Chronic Disease; Clopenthixol; Double-Blind Method; Female; Follow-Up Studies; Haloperidol; Humans; Male; Middle Aged; Psychiatric Status Rating Scales; Schizophrenia; Schizophrenic Psychology; Severity of Illness Index; Sex Factors

Forty-five patients were entered into a 24-week double-blind trial of clopenthixol decanoate and fluphenazine decanoate. The 24-week double-blind period was preceded by a 12-week open period. Of the 45 patients entered, 6 failed to attend the second interview and 1 left the country before the final assessment. Doses administered were in the range 100 mg 4-weekly to 400 mg 2-weekly for clopenthixol decanoate and 12.5 mg 4-weekly to 37.5 mg 3-weekly for fluphenazine decanoate. Both depot neuroleptics appeared to have an equivalent duration of action, with 200 mg clopenthixol decanoate approximately equivalent to 25 mg fluphenazine decanoate. Patients' mental state was assessed on the Brief Psychiatric Rating Scale, Clinical Global Impression, Krawiecka, Goldberg and Vaughan Rating Scale, and unwanted effects were recorded on a checklist. No differences were detected between the two drugs with regard to therapeutic activity or side-effects. It is concluded that clopenthixol decanoate is as effective and as well-tolerated a depot neuroleptic as fluphenazine decanoate.

Topics: Antipsychotic Agents; Chronic Disease; Clinical Trials as Topic; Clopenthixol; Delayed-Action Preparations; Double-Blind Method; Fluphenazine; Humans; Psychiatric Status Rating Scales; Schizophrenia; Thioxanthenes

Nineteen chronic schizophrenics were included in an open trial to evaluate the depot neuroleptic, zuclopenthixol decanoate. The treatment period was 24 weeks and clinical evaluations were carried out every 4 weeks including the CGI, the BPRS (completed at Weeks 0, 4, 8, 16, and 24), the Hamilton Depression Scale (completed at Weeks 0, 12, and 24), and a side-effects check list. Patients received 200 mg zuclopenthixol decanoate intramuscularly at intervals dependent on the severity of the illness. Statistically significant reductions were found for most of the symptoms on the BPRS. The reduction was already seen after 4 weeks of treatment. A clear improvement was also recorded on the Hamilton Depression Scale. The frequency of side-effects was low and decreased during the treatment period. The side-effects recorded were mild and, according to the CGI, they did not interfere with the patients' functioning except in 1 case (Week 24). It is concluded that zuclopenthixol decanoate is an effective and well-tolerated drug in the maintenance treatment of chronic schizophrenia.

Topics: Adult; Aged; Chronic Disease; Clopenthixol; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Psychiatric Status Rating Scales; Schizophrenia; Thioxanthenes

A study was carried out in 68 chronic schizophrenic out-patients to assess the therapeutic effectiveness and tolerance of long-term maintenance treatment with a depot preparation of clopenthixol decanoate. Patients received 200 mg to 600 mg doses by intramuscular injection every 2 to 3 weeks for a mean treatment period of 20.3 months. Clinical symptomatology was assessed at regular intervals using the Brief Psychiatric Rating Scale (BPRS) and any adverse effects were recorded against a standard check-list. The results showed that there was a significant reduction in total and factor composition BPRS scores after treatment in all patients, the improvement becoming generally evident by the sixth month of treatment. Few autonomic and neurological side-effects were reported.

Topics: Adult; Aged; Antipsychotic Agents; Chronic Disease; Clopenthixol; Female; Humans; Male; Middle Aged; Psychiatric Status Rating Scales; Schizophrenia; Thioxanthenes; Time Factors

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

Nineteen chronic schizophrenic in-patients were entered into a 12-week open study of intramuscular clopenthixol decanoate. Fourteen patients completed the full 12-week treatment period; 3 were withdrawn due to inadequate clinical response or untoward adverse effects, and 2 were discharged and lost to follow-up. Doses administered were in the range 200 to 400 mg, weekly or fortnightly. Patients were assessed weekly using the Brief Psychiatric Rating Scale (BPRS). Nurses' Observation Scale for In-patient Evaluation (NOSIE-30) and the Clinical Global Impression (CGI). Unwanted effects were recorded on a checklist. Statistically significant improvements in the overall mean scores were noted on the BPRS at every assessment and on the NOSIE-30 at every assessment except in Week 4. Unwanted effects were generally mild and they decreased during the study. The results suggest that clopenthixol decanoate is an effective, well-tolerated antipsychotic agent, suitable for the treatment of chronic, long-stay schizophrenic in-patients.

Topics: Adult; Aged; Chronic Disease; Clopenthixol; Female; Humans; Male; Middle Aged; Psychiatric Status Rating Scales; Schizophrenia; Thioxanthenes; Time Factors

Clopenthixol decanoate was given to 20 chronic schizophrenic patients for 11 months in doses ranging from 100 mg initially up to 1000 mg 3-weekly subsequently, according to clinical response and the occurrence of adverse effects. A further 3 patients received the depot injections for periods of 6 to 9 months. Improvement in individual symptoms was rated on a 4-point scale. Unwanted effects were recorded on a checklist and routine biochemical and haematological tests were carried out at the beginning and end of the treatment period. There were highly significant improvements in the mean overall symptom score and in the 5 single symptom scores (hallucinations, delusions, depression, aggressive behaviour and non-aggressive behaviour disturbance). The 2 'negative' symptoms of apathy and social withdrawal showed improvement up to 16 weeks but not at 11 months. The incidence of depression was less at the end of the study than at the time fo entry. Three patients stopped the drug after the sixth month because of extrapyramidal symptoms (2) or drowsiness (1). Three others developed severe extra-pyramidal side-effects. Unwanted effects, though recorded in 70% of patients--drowsiness and extrapyramidal symptoms were the commonest--were for the most part trivial, and were fewer and less severe than they were on entry to the study. There was no evidence of toxicity. It was considered that on the basis of this experience the drug was an effective, safe antipsychotic agent, warranting more extensive clinical trial.

Topics: Adult; Antipsychotic Agents; Chronic Disease; Clopenthixol; Delayed-Action Preparations; Female; Humans; Male; Middle Aged; Schizophrenia; Schizophrenic Psychology; Thioxanthenes