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PubMed2003

[Psychotropic drugs used in a psychiatric hospital (pharmaco-epidemiologic aspects)].

The aim of the study was to optimize psychopharmacotherapy in a big psychiatric hospital. It was conducted in Moscow Alekseev psychiatric hospital No 1, using a method of comparison of standard psychotropic treatment and medication strategy suggested by the expert group. An analysis of the treatment of 966 patients with different mental disorders revealed that 78.3% were in need of neuroleptic assignment that was in line with routine practice. The expert's conclusions were postulated as follows: a need in phenothyazines is significantly lower than that observed in practice. Xantens and tyoxantens (chlorprothixene, flupentixol, zuclopenthixol, zuclopenthixol decanoate, zuclopenthixol acetate), benzamides (sulpiride) and such atypical antipsychotics as risperidone, olanzapine and quentiapine are underused in the treatment. Comparing to usual practice, more patients (35.8%) need antidepressants treatment. Thymoleptics should be assigned in greater daily doses. Selective inhibitors of serotonin reuptake (paroxetine, fluoxetine, citalopram, sertraline), reversible MAO A inhibitors (pyrazidolum), "double-action" drugs (mirtazapine, milnacipran) are recommended for wider usage. Less patients (33.4%) are in need of tranquilizers, though a number of medications used is consistent with a recommended one. Normothymics may be assigned to essentially less part of the patients and 18% of them need nootropics that is consistent with routine practice.

Antidepressive Agents↗
PubMed2004

The impact of neuroleptic medication on seizure threshold and duration in electroconvulsive therapy.

INTRODUCTION: In most patients diagnosed with psychotic depression or schizophrenia and treated with electroconvulsive therapy, parallelly administered antipsychotic medication cannot be stopped. Antipsychotic drugs can influence both seizure threshold and seizure activity in different ways. PATIENTS AND METHOD: The present study processes the data of 77 patients treated parallelly with electroconvulsive therapy and antipsychotic drugs. Oral doses of the antipsychotic medication administered the day before the electroconvulsive therapy, stimulus intensity, seizure durations, and impedance were analysed from session to session. RESULTS: One group of antipsychotics (haloperidol, fluphenazine, risperidone, sulpirid) was not found to influence seizure activity: there was no significant difference in EEG and EMG registered seizure duration or in stimulus intensity between the treated and non-treated group. However, significant difference was found between the next treated and non-treated groups in 40% of the sessions in case of olanzapine, in 50% of the sessions in case of clozapine and in 57% of the sessions in case of zuclopenthixol in EEG or EMG registered seizure duration as well as in stimulus intensity. In the third group (quetiapine) there was a significant difference in each session (2nd session: EMG, p=0.02; 5th session: EEG, p=0.05, EMG, p=0.04). Most of the antipsychotics (olanzapine, clozapine, zuclopenthixol) have been shown to possess epileptogenic properties; only quetiapine reduces seizure activity. CONCLUSION: In the clinical use of olanzapine, clozopine and zuclopenthixol seems epileptogenic, whereas in the case of quetiapine seizure reducing properties must be taken into account. Together with the consideration of the accompanying somatic and neurologic disturbances and with the concomitant medications this can influence the treatment of choice.

Adult↗
PubMed1991

Zuclopenthixol acetate in viscoleo in acutely disturbed psychotic patients.

This report describes an open pilot study of ten acutely disturbed and agitated psychotic patients who received CPT-A zuclopenthixol injections. The dosage ranged from 50 mg to 100 mg. Sedative effects were noticed already after 2 hours, and the patients were all sleepy and sedated after 8 hours. There was a definite improvement in the CGI within 24 hours. The BPRS improved within 24 hours, having the greatest effect on activation, anxiety, depression, and hostile suspiciousness. These effects were sufficient to control these patients. The findings show a rapid onset of therapeutic effect, with no side effects, a duration of 2-3 days and a good local tolerability.

Acute Disease↗
PubMedDate not supplied

Open clinical study of Clopixol-Acuphase (zuclopenthixol acetate) treatment followed by Clopixol Depot in acute psychoses with long-term course tendency.

The evolution of 28 patients displaying acute forms of psychoses (schizophrenia, mania, exacerbation of psychosis in chronic cases) was studied under the treatment with Acuphase Acetate continued with Clopixol Depot. In both therapies a tioxantenic neuroleptic is involved for the acute form of the illness (Acuphase) and for the maintenance treatment (Clopixol Depot). The assessment of the results was carried out on individual observation files using Global Rating Scale (G.R.S.), B.P.R.S. and paraclinical measurement to appreciate the biological tolerance. Favourable effects of treatment were evident in the first 4 days and in six cases even within the first 24 hours. The whole group of patients showed a significant decrease of morbidity evolving from a high severity to a medium and reduced one. The biological tolerance was very good, 6 to 12 months' care.

Acute Disease↗
PubMed1988

[Use of Clopixol Acutard 50 and 100 mg (zuclopenthixol acetate) as a therapeutic drug in crisis at the Cery psychiatric hospital].

After reviewing the different pharmacological treatments of psychotic states, the author presents an evaluation of the clinical effectiveness of Clopixol Acutard (zuclopenthixol acetate in a viscoleo solution): 48% of the 23 patients (14 acute psychoses and 9 acute phases in chronic psychotic patients) respond well to the treatment, and only 17% suffered from important side effects, which demonstrates the good tolerance of the medication. Clopixol Acutard convinces by its rapid effect and with a mean of 5 injections leads to sedation, which is particularly helpful in patients with paranoid symptoms. The treatment interval, i.e. an injection every 2 or 3 days, is appreciated by the patients as well as by the therapists, for it establishes a less intrusive relationship.

Adult↗
PubMed1989

Zuclopenthixol and haloperidol/levomepromazine in the treatment of elderly patients with symptoms of aggressiveness and agitation: a double-blind, multi-centre study.

A double-blind study was carried out in 48 hospitalized, elderly demented patients with key symptoms of aggressiveness and agitation to evaluate the efficacy and tolerability of zuclopenthixol compared with that of haloperidol/levomepromazine. Patients were allocated at random to receive initial doses of either 4 mg zuclopenthixol daily or 1 mg haloperidol in the morning and 5 mg levomepromazine in the evening over a period of 4 weeks. In Week 4, the mean daily dose was 4.8 mg zuclopenthixol and 1.6/7.6 mg haloperidol/levomepromazine, respectively. After 1 week, the severity of illness was already significantly reduced, and was further reduced after 2 and 4 weeks of treatment in both groups: the reduction, however, was most pronounced in the zuclopenthixol group and after 2 weeks this difference was significant. Side-effects were few. The results of the study indicate that, whilst both zuclopenthixol and haloperidol/levomepromazine were effective and well tolerated in these elderly patients with aggressiveness and agitation, onset of therapeutic effect appeared more rapidly with zuclopenthixol, which furthermore provides the practical advantage that it may be administered once a day.

Aged↗
PubMed1989

Acute psychotic disorders treated with 5% zuclopenthixol acetate in 'Viscoleo' ('Cisordinol-Acutard'), a global assessment of the clinical effect: an open multi-centre study.

In an open clinical multi-centre trial carried out in five Danish psychiatric departments, patients suffering from acute psychosis including mania or exacerbation of chronic psychosis were given injections of 5% zuclopenthixol acetate in 'Viscoleo'. The object of the trial was to evaluate the treatment by means of a global assessment of the severity of the psychosis, the therapeutic effect and the side-effects. The results showed that the treatment was rapidly effective in reducing the severity of psychotic symptoms combined with an advantageous unspecific sedation. The side-effect profile was similar to that after other neuroleptics. Special attention should be paid, however, to a possible occurrence of acute dystonia which was observed particularly in young men with acute psychosis.

Acute Disease↗
PubMed1985

A clinical assessment of zuclopenthixol dihydrochloride (Clopixol tablets) in the treatment of psychotic illness.

An open, multi-centre study was carried out in 69 patients with an acute psychotic episode to assess the efficacy and side-effects of treatment with oral zuclopenthixol dihydrochloride. Patients were treated until the acute episode was considered terminated by the clinician and, although dosage could be adjusted to allow optimum clinical response, the majority received 25 mg zuclopenthixol dihydrochloride 3-times daily throughout the trial period. Assessments were made before and during treatment using the BPRS and CGI rating scales and a check-list of side-effects. The results showed that 55 (80%) patients had a successful response to treatment. Almost half (33) of the patients responded fully to the drug within 3 weeks and by the end of 5-weeks' treatment this had increased to over 70% (49). A further 6 patients responded after 6 to 9 weeks of treatment. The drug was generally well tolerated and the majority of patients had either no side-effects or side-effects which did not overtly affect performance.

Adolescent↗
PubMed1988

Zuclopenthixol and melperon in the treatment of elderly patients: a double-blind, controlled, multi-centre study.

A double-blind study was carried out in 53 elderly patients in 6 geriatric nursing homes to assess the effectiveness of the neuroleptics, zuclopenthixol and melperon (flubuperone), in the relief of restlessness, aggressiveness and other such symptoms. The initial daily dose was 4 mg zuclopenthixol or 75 mg melperon, increased if necessary over the treatment period of 4 weeks. Assessments were made on entry and after 1, 2 and 4 weeks of treatment of the overall severity of illness and of individual symptoms. The results showed that there was significant improvement in the condition of patients in both treatment groups and a significant reduction in mean total as well as in the main single symptom scores. These changes were already apparent after 1 week of treatment. Although there was a tendency for faster improvement in the zuclopenthixol group, there were no significant differences between the groups in any of the parameters assessed. Side-effects were few and generally mild and transient.

Aged↗
PubMed1988

Zuclopenthixol decanoate in the management of behavioural disorders in mentally handicapped patients.

One hundred and sixteen mentally handicapped patients with behavioural disorders were studied in a double-blind clinical comparison of zuclopenthixol decanoate injection (mean dosage 123 mg/week) and placebo. The study consisted of a 4-week open phase, in which all patients were treated with zuclopenthixol decanoate, followed by a 12-week double-blind phase where approximately half of the patients were changed to placebo. Patients were assessed every 2 weeks using the Clinical Global Impression, the Nurse's Observation Scale for In-patient Evaluation, a specific behaviour rating scale designed for this study and a side-effects check-list. Fourteen patients in the placebo group were withdrawn because of an increase in the frequency and severity of their behavioural disorders compared to only 4 in the zuclopenthixol decanoate group. Analyses of the rating scales of the patients remaining in the study also showed zuclopenthixol decanoate to be superior to placebo in the treatment of mentally handicapped patients with behavioural disorders. Side-effects in general were not a problem and did not affect treatment.

Adolescent↗