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Phenothiazine Reduction As a Cause of Rehospitalization

Phenothiazine Reduction As a Cause of Rehospitalization Abstract WE RECENTLY studied a group of schizophrenic outpatients to find out if reduction in phenothiazine dosage, ordered by a physician, is a significant cause of readmission to a hospital. Previous controlled studies have shown the deleterious effect, in schizophrenia, of withdrawing phenothiazines.1-8 Some of these have been of the type where the phenothiazine was withdrawn and replaced by a placebo1-7 with the patient's physician remaining "blind." In several of these studies readmission to a hospital has been used as a criterion of deterioration.2-4,8 It might be supposed that when the reduction in dosage is deliberately ordered by a physician, the deleterious results would be less likely than when the drug is capriciously stopped as part of a double-blind, placebo-controlled, experiment. (Analogy with other drugs, such as digitalis for heart failure, or steroids for rheumatoid arthritis, would certainly suggest this.) Forrest, however, has References 1. Good, W. W.; Sterling, M.; and Holtzman, W.: Termination of Chlorpromazine With Schizophrenic Patients , Amer J Psychiat 115:443, 1958. 2. Engelhardt, D., et al: Phenothiazines in Prevention of Psychiatric Hospitalization: II , JAMA 186:981, 1963.Crossref 3. Engelhardt, D., et al: Phenothiazines in Prevention of Psychiatric Hospitalization: III , Arch Gen Psychiat 11:162, 1964.Crossref 4. Katz, M. M., and Cole, J. O.: Research on Drugs and Community Care , Arch Gen Psychiat 7:345, 1962.Crossref 5. Diamond, L. S., and Marks, J. B.: Discontinuance of Tranquilizers Among Chronic Schizophrenic Patients Receiving Maintenance Dosage , J Nerv Ment Dis 131:247, 1960.Crossref 6. Tuteut, W.; Steller, R.; and Glotrer, J.: Discharged Mental Hospital Chlorpromazine Patients , Dis Nerv Syst 20:512, 1959. 7. Whittaker, C. B., and Hoy, R. M.: Withdrawal of Perphenazine in Chronic Schizophrenics , Brit J Psychiat 109:422, 1963.Crossref 8. Orlinsky, N., and D'Elia, E.: Rehospitalization of Schizophrenic Patient , Arch Gen Psychiat 10:47, 1964.Crossref 9. Forrest, F. M.; Geiter, C. W.; and Snow, H. L.: Drug Maintenance Problems of Rehabilitated Mental Patients: Current Drug Dosage "Merry-Go-Round," Amer J Psychiat 121:33, 1964. 10. American Psychiatric Association: Diagnostic and Statistical Manual: Mental Disorders, Washington, DC: the Association, 1952. 11. Clark, J. A., and Mallett, B. L.: Follow-Up Study of Schizophrenia and Depression in Young Adults , Brit J Psychiat 109:491, 1963.Crossref 12. Engelhardt, D.: Influence of Previous Hospitalization on Clinical Course of Psychopharmacologically Treated Schizophrenic Outpatients , Compr Psychiat 4:337, 1963.Crossref 13. Lindley, C. J.: " V.A. Hospital Survey of Tranquilizing Drugs ," in Transactions of the Second (1957) Research Conference on Chemotherapy in Psychiatry , Washington, DC: Veterans Administration Department of Medicine and Surgery, 1958, vol 2, p 29. 14. Klerman, M. A.: in Transactions of the Sixth (1961) Research Conference on Chemotherapy in Psychiatry, Washington, DC: Veterans Administration Department of Medicine and Surgery, 1961, vol 6, p 32. 15. Brain, W. R.: Diseases of Nervous System , London: Oxford University Press, 1955. 16. Grinker, R. R.: Neurology , Springfield, Ill: Charles C Thomas, Publisher, 1934. 17. Lennox, W. C., and Lennox, M. A.: Epilepsy and Related Disorders , Boston: Little, Brown & Co., 1960. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Phenothiazine Reduction As a Cause of Rehospitalization

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References (17)

Publisher
American Medical Association
Copyright
Copyright © 1965 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1965.01720360058009
Publisher site
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Abstract

Abstract WE RECENTLY studied a group of schizophrenic outpatients to find out if reduction in phenothiazine dosage, ordered by a physician, is a significant cause of readmission to a hospital. Previous controlled studies have shown the deleterious effect, in schizophrenia, of withdrawing phenothiazines.1-8 Some of these have been of the type where the phenothiazine was withdrawn and replaced by a placebo1-7 with the patient's physician remaining "blind." In several of these studies readmission to a hospital has been used as a criterion of deterioration.2-4,8 It might be supposed that when the reduction in dosage is deliberately ordered by a physician, the deleterious results would be less likely than when the drug is capriciously stopped as part of a double-blind, placebo-controlled, experiment. (Analogy with other drugs, such as digitalis for heart failure, or steroids for rheumatoid arthritis, would certainly suggest this.) Forrest, however, has References 1. Good, W. W.; Sterling, M.; and Holtzman, W.: Termination of Chlorpromazine With Schizophrenic Patients , Amer J Psychiat 115:443, 1958. 2. Engelhardt, D., et al: Phenothiazines in Prevention of Psychiatric Hospitalization: II , JAMA 186:981, 1963.Crossref 3. Engelhardt, D., et al: Phenothiazines in Prevention of Psychiatric Hospitalization: III , Arch Gen Psychiat 11:162, 1964.Crossref 4. Katz, M. M., and Cole, J. O.: Research on Drugs and Community Care , Arch Gen Psychiat 7:345, 1962.Crossref 5. Diamond, L. S., and Marks, J. B.: Discontinuance of Tranquilizers Among Chronic Schizophrenic Patients Receiving Maintenance Dosage , J Nerv Ment Dis 131:247, 1960.Crossref 6. Tuteut, W.; Steller, R.; and Glotrer, J.: Discharged Mental Hospital Chlorpromazine Patients , Dis Nerv Syst 20:512, 1959. 7. Whittaker, C. B., and Hoy, R. M.: Withdrawal of Perphenazine in Chronic Schizophrenics , Brit J Psychiat 109:422, 1963.Crossref 8. Orlinsky, N., and D'Elia, E.: Rehospitalization of Schizophrenic Patient , Arch Gen Psychiat 10:47, 1964.Crossref 9. Forrest, F. M.; Geiter, C. W.; and Snow, H. L.: Drug Maintenance Problems of Rehabilitated Mental Patients: Current Drug Dosage "Merry-Go-Round," Amer J Psychiat 121:33, 1964. 10. American Psychiatric Association: Diagnostic and Statistical Manual: Mental Disorders, Washington, DC: the Association, 1952. 11. Clark, J. A., and Mallett, B. L.: Follow-Up Study of Schizophrenia and Depression in Young Adults , Brit J Psychiat 109:491, 1963.Crossref 12. Engelhardt, D.: Influence of Previous Hospitalization on Clinical Course of Psychopharmacologically Treated Schizophrenic Outpatients , Compr Psychiat 4:337, 1963.Crossref 13. Lindley, C. J.: " V.A. Hospital Survey of Tranquilizing Drugs ," in Transactions of the Second (1957) Research Conference on Chemotherapy in Psychiatry , Washington, DC: Veterans Administration Department of Medicine and Surgery, 1958, vol 2, p 29. 14. Klerman, M. A.: in Transactions of the Sixth (1961) Research Conference on Chemotherapy in Psychiatry, Washington, DC: Veterans Administration Department of Medicine and Surgery, 1961, vol 6, p 32. 15. Brain, W. R.: Diseases of Nervous System , London: Oxford University Press, 1955. 16. Grinker, R. R.: Neurology , Springfield, Ill: Charles C Thomas, Publisher, 1934. 17. Lennox, W. C., and Lennox, M. A.: Epilepsy and Related Disorders , Boston: Little, Brown & Co., 1960.

Journal

Archives of General Psychiatry – American Medical Association

Published: Jun 1, 1965

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