Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-18T18:54:45.825Z Has data issue: false hasContentIssue false
  • English
  • Français

Large Variations of Plasma Levels During Maintenance Treatment with Depot Neuroleptics

Published online by Cambridge University Press:  02 January 2018

Eva Tuninger  and
Sten Levander
Sten Levander
Affiliation:
Department of Psychiatry, Malmö Lund University
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Stability of neuroleptic medication has been associated with optimal clinical effect and minimal side-effects. Depot administration is assumed to yield better stability.

Method

Thirty patients on depot neuroleptic treatment were followed during three years with repeated measurements of plasma level and concurrent ratings of clinical symptoms and side-effects.

Results

Of 120 blood samples 35 (29%) measurements were outside ± 2 s.d. measurement error (expected 5%). Perphenazine levels were more variable (46%) than haloperidol (25%) and flupenthixol (12.5%). No relationship was found between side-effect ratings and fluctuations of plasma levels.

Conclusion

Depot neuroleptic medication does not eliminate a clinically unwanted and sometimes marked variation in plasma level.

Type
Papers
Information
The British Journal of Psychiatry , Volume 169 , Issue 5 , November 1996 , pp. 618 - 621
Copyright
Copyright © Royal College of Psychiatrists, 1996 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Baldessarini, R. J., Cohen, B. M. & Teicher, M. H. (1988) Significance of neuroleptic dose and plasma level in the pharmacological treatment of psychoses. Archives of General Psychiatry, 45, 79–91.CrossRefGoogle ScholarPubMed
Barnes, T. R. E. (1989) A rating scale for drug-induced akathisia. British Journal of Psychiatry; 154, 672–676.CrossRefGoogle ScholarPubMed
Bolvig Hansen, L., Elley, J. & Rosted Christensen, T. (1979) Plasma levels of perphenazine and its major metabolites during simultaneous treatment with anticholinergic drugs. British Journal of Clinical Pharmacology, 7, 75–80.CrossRefGoogle Scholar
Burnett, P. L., Galletly, C. A., Moyle, R. J., et al (1993) Low-dose depot medication in schizophrenia. Schizophrenia Bulletin, 19, 155–164.CrossRefGoogle ScholarPubMed
Cockshott, W. P., Thompson, G. T., Howlett, L. J., et al (1982) Intramuscular or intralipomatous injections? New England Journal of Medicine, 5, 356–358.CrossRefGoogle Scholar
Darby, J. K., Pasta, D. J., Dabiri, L., et al (1995) Haloperidol dose and blood level variability: toxicity and interindividual and intraindividual variability in the nonresponder patient in the clinical practice setting. Journal of Clinical Psychopharmacology, 15, 334–340.CrossRefGoogle ScholarPubMed
Nyberg, S., Farde, L., Halldin, C., et al (1995) D2 dopamine receptor occupancy during low-dose treatment with haloperidol decanoate. American Journal of Psychiatry, 152, 173–178.Google ScholarPubMed
Simpson, G. M. & Angus, J. W. (1970) A rating scale for extra pyramidal side-effects. Acta Psychiatrica Scandinavica, Suppl. 212, 11–19.CrossRefGoogle Scholar
Suy, E., Woestenborghs, R. & Heykants, J. (1982) Bioavailability and clinical effect of two different concentrations of haloperidol decanoate. Current Therapeutic Research, 31, 982–991.Google Scholar
Van Putten, T., Marder, S. R., Mintz, J., et al (1992) Haloperidol plasma levels and clinical response: a therapeutic window relationship. American Journal of Psychiatry, 149, 500–505.Google ScholarPubMed
Vinarová, E., Vinar, O. & Kalvach, Z. (1984) Smokers need higher doses of neuroleptic drugs. Biological Psychiatry, 19, 1265–1268.Google ScholarPubMed
Volavka, J., Cooper, T., Czobor, P., et al (1992) Haloperídol blood levels and clinical effects. Archives of General Psychiatry, 49, 354–361.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.