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A THERAPEUTIC APPROACH TO ANERGIC, CHRONIC SCHIZOPHRENICS WITH TRIFLUOPERAZINE
Author(s) -
Ohno Yoshihiro
Publication year - 1964
Publication title -
psychiatry and clinical neurosciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.609
H-Index - 74
eISSN - 1440-1819
pISSN - 1323-1316
DOI - 10.1111/j.1440-1819.1964.tb00017.x
Subject(s) - trifluoperazine , medicine , rating scale , therapeutic effect , drug , therapeutic index , maintenance dose , brief psychiatric rating scale , placebo , chlorpromazine , refractory (planetary science) , pharmacology , psychology , psychosis , psychiatry , developmental psychology , physics , alternative medicine , pathology , astrobiology , calmodulin , calcium
Summary A relatively new, phenothiazine derivative, trifluoperazine was selected and its pharmacological study was carried out in terms of clinical efficacy and the usefulness of the drug, as a therapeutic approach to the so‐called backward, anergic, withdrawn schizophrenic patients who have been refractory to the previous treatment. The drug was administered to 55 chronic schizophrenics who have been ill over 3 years (average: 8.2 years) and the duration of treatment ranged from 3 months to 12 months. A double‐blind method was applied in this study and the patients were divided into 3 groups: A, the drug group during 3‐month project, 30 cases, B, out‐patient clinic basis, 15 cases, and C, the placebo group during 3‐month project but after the project, received trifluoperazine, 10 cases. In rating the patients, “Psychiatric Evaluating Scale” (P.E.S.) and “Behavioral Rating Scale” (B.R.S.) were used for uniformity in assessing the therapeutic responses. Regarding the dosage of trifluoperazine, the effective daily dose ranged from 7.5 mg to 30 mg, maintenance dose ranged from 7.5 mg to 15 mg per day and the tolerable maximum dose administered in this study was 60 mg daily. No better result was obtained with the dose over 30 mg per day. The improvement rate of 3‐month project in the drug group (Group A) was 56.6% and the result of 12‐month follow up (60%) was about the same comparing with that of Group A. Generally, noticeable improvement occurred 2 or 3 weeks after the drug administration. In terms of target symptom effects, trifluoperazine proved to activate anergic, withdrawn chronic schizophrenics, particularly, in improving apathetic or dull affectivity, personal appearance, hostile and negativistic attitudes and delusions, hallucinations, psychomotor excitement, in some cases. In this study, no correlation between the occurrence of extra‐pyramidal syndroms or other side effects and clinical improvement was found. Trifluoperazine caused various degrees of side effects, most frequently, tremor of extremities and akathisia at the dose over 7.5 mg or frequently at the dose of 20 mg per day. These side effects, however, in most cases, were manageable by the administration of anti‐parkinsonian agent “Artane” or by lowering the dosage in some cases. On out clinic basis, prophylactic administration of “Artane” was needed in sensitive cases to a drug and the optimum dose ranged from 7.5 mg to 15 mg daily. Laboratory examinations were all within normal limits. There were no cases of clinical jaundice, agranulocytosis, convulsion and no cases with hypotensive crisis. None of the patients during the course of treatment showed the signs of photosensitivity.