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Outcome and risks of ultra-long-term treatment with an oral neuroleptic drug

Relationship between perazine serum levels and clinical variables in schizophrenic outpatients

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Summary

In 33 schizophrenic patients treated continuously as outpatients with perazine over two decades, the rehospitalization rate decreased from 0.58 before treatment to 0.07 during treatment. The intensity of psychopathologic symptoms and the side effects were found to be remarkably low. The high intraindividual constancy of perazine plasma levels and the tight correlation between dose and plasma levels indicated satisfactory patient compliance. Plasma levels amounted to only 25% of those under acute treatment and correlated positively with the severity of the disease. Higher plasma levels coincided with more frequent side effects such as slightly pathologic liver function and moderate impairment of oral glucose tolerance. The results suggest that low-dose maintenance treatment of schizophrenic patients with oral neuroleptics is effective and relatively safe.

Zusammenfassung

Bei 33 schizophrenen Patienten, die seit durchschnittlich 18 Jahren kontinuierlich ambulant mit Perazin behandelt wurden, sank die Rehospitalisierungsrate pro Jahr von 0,58 vor auf 0,07 während der Behandlung. Die Intensität der psychopathologischen Symptomatik sowie der Nebenwirkungen waren bemerkenswert gering. Die hohe intraindividuelle Konstanz der Perazin-Plasmaspiegels und die enge Korrelation zwischen Dosis und Plasmaspiegel sprach für eine befriedigende Compliance (Behandlungstreue) der Patienten. Die Höhe der Plasmaspiegel betrug nur etwa ein Viertel der Spiegel, die während einer Akutbehandlung gemessen werden, und sie korrelierte positiv mit der Schwere der Erkrankung. Je höher die Plasmaspiegel waren, desto häufiger waren Nebenwirkungen wie geringfügig pathologische Leberfunktion und eine mäßige Verschlechterung der oralen Glucosetoleranz.

Die Ergebnisse legen den Schluß nahe, daß eine niedrig dosierte Langzeitbehandlung schizophrener Patienten mit oralen Neuroleptika effektiv und relativ sicher ist.

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Authors and Affiliations

  1. Department of Psychiatry, Free University of Berlin, Eschenallee 3, D-1000, Berlin 19

    A. Pietzcker, A. Poppenberg, J. Schley & B. Müller-Oerlinghausen

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  1. A. Pietzcker
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  2. A. Poppenberg
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  3. J. Schley
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  4. B. Müller-Oerlinghausen
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Supported by Deutsche Forschungsgemeinschaft, Bonn-Bad-Godesberg (He 916/2 Clinical Pharmacology)

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Pietzcker, A., Poppenberg, A., Schley, J. et al. Outcome and risks of ultra-long-term treatment with an oral neuroleptic drug. Arch. F. Psychiatr. U. Z. Neur. 229, 315–329 (1981). https://doi.org/10.1007/BF01833160

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  • DOI: https://doi.org/10.1007/BF01833160

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