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Plasma Levels of Fluphenazine in Patients Receiving Fluphenazine Decanoate Relationship to Clinical Response

Published online by Cambridge University Press:  02 January 2018

Stephen R. Marder ,
Kamal K. Midha ,
Theodore Van Putten ,
Manickam Aravagiri ,
Edward M. Hawes ,
John W. Hubbard ,
Gordon Mckay  and
Jim Mintz
Stephen R. Marder*
Affiliation:
West Los Angeles V A Medical Center, Brentwood Division, and University of California, Los Angeles, USA
Kamal K. Midha
Affiliation:
College of Pharmacy, University of Saskatchewan, Saskatoon, Canada
Theodore Van Putten
Affiliation:
West Los Angeles V A Medical Center, Brentwood Division, and University of California, Los Angeles, USA
Manickam Aravagiri
Affiliation:
Department of Psychiatry, University of California, Los Angeles, USA
Edward M. Hawes
Affiliation:
College of Pharmacy, University of Saskatchewan, Saskatoon, Canada
John W. Hubbard
Affiliation:
College of Pharmacy, University of Saskatchewan, Saskatoon, Canada
Gordon Mckay
Affiliation:
College of Pharmacy, University of Saskatchewan, Saskatoon, Canada
Jim Mintz
Affiliation:
University of California, Los Angeles, USA
*
∗West LA V A Medical Center, Brentwood Division, 11301 Wilshire Boulevard, Los Angeles, CA 90073
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Abstract

The levels of fluphenazine and fluphenazine sulphoxide in schizophrenic patients who were randomly assigned to receive either 5 mg or 25 mg of fluphenazine decanoate every two weeks were monitored. Patients treated with 25 mg of fluphenazine decanoate required three months to reach a steady-state plasma level, indicating that those patients who are being converted from oral to depot fluphenazine should continue to receive oral supplementation during the first three months of treatment with fluphenazine decanoate. Plasma levels of fluphenazine sulphoxide were lower than levels of fluphenazine. At six and nine months following randomisation, there was a statistically significant relationship between lower fluphenazine plasma levels and an increased risk of psychotic exacerbations. A relatively weak relationship was found between fluphenazine plasma levels and akinesia, but non-significant relationships between fluphenazine levels and other neurological side-effects including akathisia, retardation, and tardive dyskinesia. Monitoring the plasma levels may be helpful to clinicians who are attempting to treat stabilised patients with the lowest effective dose of fluphenazine decanoate.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 158 , Issue 5 , May 1991 , pp. 658 - 665
Copyright
Copyright © Royal College of Psychiatrists, 1991 

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