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Low- and Conventional-Dose Maintenance Therapy With Fluphenazine Decanoate: Two-Year Outcome

Low- and Conventional-Dose Maintenance Therapy With Fluphenazine Decanoate: Two-Year Outcome Abstract • We evaluated the effectiveness and the side effects of what we defined as low (5-mg) and conventional (25-mg) doses of fluphenazine decanoate administered every two weeks in a double-blind comparison. Subjects were 66 patients who fulfilled DSM-III criteria for schizophrenic disorder. Evaluation of the survival with each dose revealed no significant difference at one year, but significantly better survival was seen with the 25-mg dose (64%) than the 5-mg dose (31%) at two years. There was no significant difference in survival when the clinician was permitted to make a dosage adjustment up to 10 mg in the lowdose group and 50 mg in the higher-dose group when the patient demonstrated evidence of a symptomatic exacerbation. Patients assigned to the higher dose appeared to feel more uncomfortable during the early months of the study, as indicated by significantly higher scores on subscales of the Hopkins Symptom Checklist-90R and higher side effect scores for retardation and akathisia. Implications for clinical practice are discussed. References 1. Marder SR, Van Putten T, Mintz J, McKenzie J, Lebell M, Faltico G, May PRA: Costs and benefits of two doses of fluphenazine . Arch Gen Psychiatry 1984;41:1025-1029.Crossref 2. Kane JM, Rifkin A, Woerner M, Reardon G, Sarantakos S, Schiebel O, Ramos-Lorenzi J: Low-dose neuroleptic treatment of outpatient schizophrenics: I. Preliminary results for relapse rates . Arch Gen Psychiatry 1983;40:893-896.Crossref 3. Goldstein MS, Rodnick EM, Evans JR, May PRA, Steinberg MR: Drugs and family therapy in the aftercare of acute schizophrenics . Arch Gen Psychiatry 1978;35:1169-1177.Crossref 4. Lehmann HE, Wilson WH, Deutsch M: Minimal maintenance medication: Effects of three dose schedules on relapse rates and symptoms in chronic schizophrenic outpatients . Compr Psychiatry 1983;24:293-303.Crossref 5. Hogarty GE, Schooler N, Ulrich RF, Mussare F, Ferro P, Herron E: Fluphenazine and social therapy in the aftercare of schizophrenic patients: Relapse analysis of two-year controlled study of fluphenazine decanoate and fluphenazine hydrochloride . Arch Gen Psychiatry 1979;36:1283-1294.Crossref 6. Wistedt B, Jorgensen A, Wiles D: A depot neuroleptic withdrawal study: Plasma concentration of fluphenazine and flupenthixol and relapse frequency . Psychopharmacology 1982;78:301-304.Crossref 7. Hogarty GE, Goldberg SC, Schooler NR, Ulrich RF, the Collaborative Study Group: Drug and sociotherapy in the aftercare of schizophrenic patients: II. Two-year relapse rates . Arch Gen Psychiatry 1974;31:603-608.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Low- and Conventional-Dose Maintenance Therapy With Fluphenazine Decanoate: Two-Year Outcome

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Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1987.01800180028005
Publisher site
See Article on Publisher Site

Abstract

Abstract • We evaluated the effectiveness and the side effects of what we defined as low (5-mg) and conventional (25-mg) doses of fluphenazine decanoate administered every two weeks in a double-blind comparison. Subjects were 66 patients who fulfilled DSM-III criteria for schizophrenic disorder. Evaluation of the survival with each dose revealed no significant difference at one year, but significantly better survival was seen with the 25-mg dose (64%) than the 5-mg dose (31%) at two years. There was no significant difference in survival when the clinician was permitted to make a dosage adjustment up to 10 mg in the lowdose group and 50 mg in the higher-dose group when the patient demonstrated evidence of a symptomatic exacerbation. Patients assigned to the higher dose appeared to feel more uncomfortable during the early months of the study, as indicated by significantly higher scores on subscales of the Hopkins Symptom Checklist-90R and higher side effect scores for retardation and akathisia. Implications for clinical practice are discussed. References 1. Marder SR, Van Putten T, Mintz J, McKenzie J, Lebell M, Faltico G, May PRA: Costs and benefits of two doses of fluphenazine . Arch Gen Psychiatry 1984;41:1025-1029.Crossref 2. Kane JM, Rifkin A, Woerner M, Reardon G, Sarantakos S, Schiebel O, Ramos-Lorenzi J: Low-dose neuroleptic treatment of outpatient schizophrenics: I. Preliminary results for relapse rates . Arch Gen Psychiatry 1983;40:893-896.Crossref 3. Goldstein MS, Rodnick EM, Evans JR, May PRA, Steinberg MR: Drugs and family therapy in the aftercare of acute schizophrenics . Arch Gen Psychiatry 1978;35:1169-1177.Crossref 4. Lehmann HE, Wilson WH, Deutsch M: Minimal maintenance medication: Effects of three dose schedules on relapse rates and symptoms in chronic schizophrenic outpatients . Compr Psychiatry 1983;24:293-303.Crossref 5. Hogarty GE, Schooler N, Ulrich RF, Mussare F, Ferro P, Herron E: Fluphenazine and social therapy in the aftercare of schizophrenic patients: Relapse analysis of two-year controlled study of fluphenazine decanoate and fluphenazine hydrochloride . Arch Gen Psychiatry 1979;36:1283-1294.Crossref 6. Wistedt B, Jorgensen A, Wiles D: A depot neuroleptic withdrawal study: Plasma concentration of fluphenazine and flupenthixol and relapse frequency . Psychopharmacology 1982;78:301-304.Crossref 7. Hogarty GE, Goldberg SC, Schooler NR, Ulrich RF, the Collaborative Study Group: Drug and sociotherapy in the aftercare of schizophrenic patients: II. Two-year relapse rates . Arch Gen Psychiatry 1974;31:603-608.Crossref

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Jun 1, 1987

References