Late (4–8 years) outcome of treatment with megadoses of fluphenazine enanthate in drug‐refractory schizophrenics

Fourteen schizophrenics who did not respond to standard doses of neuroleptics have been treated with megadoses of fluphenazine enanthate during a period of 4–8 years. Repeated attempts have been made to reduce the dose to the standard dosage. Some of the patients have gradually been transferred to maintenance treatment with standard doses, with megadoses given only during psychotic relapse. The megadose treatment has led to substantial reduction in social disablement, enabling the patients, for instance, to leave the hospital or live in an open ward. These patients have been evaluated with rating scales for psychopathology and side effects, and subjected to EEG, ECG, chest X‐ray, and examinations for skin and eye changes and local infiltrations. Laboratory tests, including anti‐DNA examination, have also been performed. These patients, treated with high total doses of different oral neuroleptics and fluphenazine depot, showed some EEG and ECG abnormalities, eye changes, slight leucopenia, a low number of staff nuclei neutrophils and infiltrations at the injection site, but these reactions did not result in any practical handicaps. The rating scales showed dyskinetic movements, usually slight, in six out of the 14 patients studied.