Depot neuroleptics

Among the difficulties in pharmacological treatment is the frequent non-compliance. The biggest determinant of compliance is the quality of a patient s relationship with his doctor. But a further way to handle the issue has involved the development of long acting products (depot neuroleptics), even though their effectiveness in the absolute or compared to oral preparations has not been adequately explored. The most commonly used depot agents are fluphenazine and haloperidol decanoate (see David et al., 2004). 

Wistedt, B., Jorgensen, A., Wiles, D. A depot neuroleptic withdrawal study. Psychopharmacology 78, 301-304, 1982. 

Angrist B, Preselow E, Rubinstein M, et al. Amphetamine response and relapse risk after depot neuroleptic discontinuation. Psychopharmacology 1985 85 277-283. 

Johnson DAW. Further observations on the duration of depot neuroleptic maintenance therapy in schizophrenia. Br J Psychiatry 1979 135 524-530. 

Tegeler J, Lehmann E. A follow-up study of schizophrenic outpatients treated with depot neuroleptics. Prog Neuropsychopharmacol 1981 5 79-90. 

Freeman H. Twelve years experience with the total use of depot neuroleptics in a defined population. In Cattabeni F, et al., eds. Long-term effects of neuroleptics (Advances in Biochemical Psychopharmacology). New York Raven Press, 1980 559-564. 

Kane JM, Woerner M, Sarantakos S. Depot neuroleptics a comparative review of standard, intermediate, and low-dose regimens. J Clin Psychiatry 1986 47(suppl) 30-33. 

Kane JM. The use of depot neuroleptics clinical experience in the United States. J Clin Psychiatry 1984 45 5-12. 

Diabetes was also more common in 63 patients taking clozapine than in 67 receiving typical depot neuroleptic drugs (299). The percentages of type 2 diabetes mellitus were 12% and 6% respectively. Nevertheless, the mechanism is not known. In six patients with schizophrenia, clozapine increased mean concentrations of blood glucose, insulin, and C peptide (300). The authors concluded that the glucose intolerance was due to increased insulin resistance. 

Hagg S, Joelsson L, Mjorndal T, Spigset O, Oja G, Dahlqvist R. Prevalence of diabetes and impaired glucose tolerance in patients treated with clozapine compared with patients treated with conventional depot neuroleptic medications. J Clin Psychiatry 1998 59(6) 294—9. 

Wistedt B. A depot neuroleptic withdrawal study. A controlled study of the clinical effects of the withdrawal of depot fluphenazine decanoate and depot flupenthixol decanoate in chronic schizophrenic patients. Acta Psychiatr Scand 1981 64(l) 65-84. 

Complications at the site of injection of depot neuroleptic drugs, including pain, bleeding or hematoma, leakage of drug from the injection site, acute inflammatory induration, and transient nodules, have been reported (SEDA-20, 43). 

Gerlach J. Depot neuroleptics in relapse prevention advantages and disadvantages. Int Clin Psychopharmacol 1995 9 SuppI 5 ... 

Clinically, depot neuroleptics possess several advantages over the short-acting oral forms. Among these, the main advantages are (a) ease of administration, (b) reliable therapeutic effect with no increase in tolerance, (c) enhanced patient compliance, (d) reduced relapse and rehospitalization rate and (f) enhanced rate and incidence of normal life reintegration and resocialization. ... 

Ereshefsky L, Saklad SR, Jann MW, et al. Future of depot neuroleptic therapy Pharmacokinetics and pharmacodynamic approaches. J Clin Psychiatry 1984 45(5 pt 2) 50-59. 

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