clopenthixol-decanoate and Psychomotor-Agitation

A double-blind study was carried out in 53 elderly patients in 6 geriatric nursing homes to assess the effectiveness of the neuroleptics, zuclopenthixol and melperon (flubuperone), in the relief of restlessness, aggressiveness and other such symptoms. The initial daily dose was 4 mg zuclopenthixol or 75 mg melperon, increased if necessary over the treatment period of 4 weeks. Assessments were made on entry and after 1, 2 and 4 weeks of treatment of the overall severity of illness and of individual symptoms. The results showed that there was significant improvement in the condition of patients in both treatment groups and a significant reduction in mean total as well as in the main single symptom scores. These changes were already apparent after 1 week of treatment. Although there was a tendency for faster improvement in the zuclopenthixol group, there were no significant differences between the groups in any of the parameters assessed. Side-effects were few and generally mild and transient.

Topics: Aged; Aged, 80 and over; Aggression; Antipsychotic Agents; Butyrophenones; Clinical Trials as Topic; Clopenthixol; Double-Blind Method; Female; Hostility; Humans; Male; Mental Disorders; Psychomotor Agitation; Random Allocation; Thioxanthenes

Persistent psychomotor agitation and psychotic ideation in patients with Alzheimer's disease are normally treated orally with antipsychotic drugs and are occasionally treated with other drugs. Neuroleptics administered intramuscularly at very low doses are an alternative, especially when the patient rejects medicine as a results of his or her anosognosia or of paranoid manifestations. We present the results we obtained after observing the effects of depot zuclopenthixol in six patients with probable Alzheimer's disease (based upon NINCDS-ADRDA criteria). Psychic abnormalities were assessed as per the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS). Possible extrapyramidal side effects were evaluated by means of the Abnormal Involuntary Movement Scale (AIMS). Initially 60 mg (0.3 ml) were administered intramuscularly and successive doses could be modified by +/-20 mg (0.1 ml) according to results seen on the various scales. During the first six weeks of treatment progressive improvement was noted on all three psychic functions scales in all patients. Between the sixth and twelfth weeks improvement continued although without significant change. The AIMS did not show significant changes in the twelve weeks of follow-up. We consider depot zuclopenthixol at low doses as efficacious in treating persistent psychomotor agitation and/or psychotic manifestations of Alzheimer's disease. No undesired side effects were observed in our group after a twelve week follow-up.

Topics: Aged; Alzheimer Disease; Antipsychotic Agents; Clopenthixol; Dose-Response Relationship, Drug; Female; Humans; Injections, Intramuscular; Male; Psychomotor Agitation