Schizophrenia perphenazine

Wu, D., Xiung, X., Wang, L. et al. (2003). A double-blind comparison trial of 1-stepholidine and perphenazine in treatment of schizophrenia. Chinese Journal of New Drugs and Clinical Remedies, 22(3), 155-60. 

Quraishi S, David A. Depot perphenazine decanoate and enanthate for schizophrenia. Cochrane Database Syst Rev 1999. Issue 4. 

One of the more methodologically rigorous studies on the utility of TCA/antipsychotic combinations in treating PMD was completed by Spiker et al. [1985). In this study, 54 patients who met criteria for depression with psychotic features on the Schedule for Affective Disorders and Schizophrenia [Endicott and Spitzer 1978) and by Research Diagnostic Criteria [Spitzer et al. 1985) were randomly selected to treatment with amitriptyline alone, perphenazine alone, or the combination of two drugs. After a 7-day placebo washout, patients were treated for 35 days with doses averaging approximately 50 mg/day of perphenazine and approximately 200 mg/day of ami-... 

Prusoff BA, Williams DH, Weissman MM, et al. Treatment of secondary depression in schizophrenia. A double-blind, placebo-controlled trial of amitriptyline added to perphenazine. Arch Gen Psychiatry 1979 36 569-575. 

Recently, a large study in the USA (CATIE) reported that perphenazine was as effective as atypical antipsychotic drugs, with the modest exception of olanzapine, and concluded that typical antipsychotic drugs are the treatment of choice for schizophrenia based on their lower cost. However, this study did not adequately consider the risk of tardivedyskinesia or the treatment history of patients in the design of this study. 

In 2005, an NIMH multisite study called CATIE compared the older neuroleptic perphenazine (Trilafon) and atypical neuroleptics olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal), and zipra-sidone (Geodon Lieberman et al., 2005a see also Nasrallah, 2007 Rosenheck et al., 2006 Weiden, 2007a). Phase I involved 1,460 patients diagnosed with schizophrenia initially randomly assigned in a doubleblind study to one of the five neuroleptics. The study lasted 18 months, with safety and tolerability outcomes evaluated at 1, 3, 6, 9, 12, 15, and 18 months. 

Rosenheck, R., Leslie, D., Sindelar, J., Miller, E., Lin, H., Stroup, T., et al. (2006). Cost-effectiveness of second generation antipsychotics and perphenazine in a randomized trial of treatment for chronic schizophrenia. American Journal of Psychiatry, 163, 2080-2089. 

A 23-year-old man with schizophrenia taking perphenazine 4 mg bd, benzatropine mesylate 2 mg/day, lithium carbonate 600 mg each morning and 900 mg at... 

GG is a 42-year-old man who has been on perphenazine as maintenance therapy for schizophrenia diagnosed at age 25. His mother is concerned because she has noticed abnormal posturing and stiffness in the movements of the body and face over the past few months. Which agent would be most appropriate to reverse and prevent further dystonic symptoms due to GG s antipsychotic therapy ... 

Perphenazine/amitriptyline are indicated in the treatment of moderate to severe anxiety or agitation and depressed mood moderate to severe depression and anxiety associated with chronic physical disease treatment of patients in whom depression and anxiety cannot be clearly differentiated and treatment of schizophrenia with associated depression. 

A woman was taking thiamazole for Graves disease, at times with various different antipsychotics including haloperidol, flupentixol, zuclopen-thixol and perphenazine for schizophrenia. Because of the severe extrapyramidal reactions and failure to control the schizophrenia, clozapine, increased over 5 days to 250 mg daily, was started instead. Within 5 days her white cell count had fallen to 2200/mm, which rose to 4000/mm, one month after both drugs were stopped. Later, after the thiamazole was stopped she was given the same dose of clozapine without these adverse effects. ... 

A 47-year-old woman with a history of schizophrenia developed fatal fulminant hepatitis after having taken 400 mg of powdered reishi daily for 2 months. She was also taking lithium, perphenazine, and trihexyphenidyl longterm. The woman had previously consumed an extract made from boiled reishi slices (dose not specified) for several years with no adverse effects. The reporting physicians indicated that the reaction could have been idiosyncratic (Wanmuang et al. 2007). 

Thiothixene, useful in treatment of schizophrenia, was also found useful in treating neurotic patients In another study, it was found as effective as the perphenazine-amitriptyline combination in treating psychoneurotic depressive symptoms4 ... 

People with schizophrenia have substantially increased rates of mortality than the general population because of chronic illness, particularly cardiovascular disease [8 ]. In an 11-year follow-up study of mortality in patients with schizophrenia (n = 66 881), the gap in life expectancy between patients with schizophrenia and the general population in Finland did not widen between 1996 (25 years) and 2006 (23 years) [9, 10/]. During that time, the proportion of use of second-generation antipsychotic drugs rose from 13% to 64%. Compared with current use of perphenazine, the highest risk of overall mortality was recorded for... 

Changes in the 10-year risk of coronary heart disease have been compared between treatment groups in 1125 patients followed for 18 months or until treatment discontinuation in the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) in schizophrenia [22 ]. The mean change in 10-year coronary heart disease risk differed significantly between treatments. Olanzapine was associated with a 0.5% increase and quetiapine with a 0.3% increase, while the risk fell in patients who used perphenazine (-0.5%), risperidone (—0.6%), and ziprasidone (—0.6%). The difference in 10-year coronary heart disease risk between olanzapine and risperidone was statistically significant. 

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