Hostname: page-component-f554764f5-68cz6 Total loading time: 0 Render date: 2025-04-11T12:28:20.856Z Has data issue: false hasContentIssue false
  • English
  • Français

Drug Prescribing for Schizophrenic Out-patients on Depot Injections

Repeat Surveys over 18 years

Published online by Cambridge University Press:  02 January 2018

D. A. W. Johnson  and
N. F. Wright
D. A. W. Johnson*
Affiliation:
University Hospital of South Manchester, West Didsbury, Manchester M20 8LR
N. F. Wright
Affiliation:
University Hospital of South Manchester, West Didsbury, Manchester M20 8LR
*
∗ Correspondence
Get access Rights & Permissions [Opens in a new window]

Abstract

Serial surveys of the prescribing practices of psychiatrists for schizophrenic out-patients over 1970–88 showed important changes. During the interval 1970–83, polypharmacy and the use of multiple neuroleptics were reduced. The total dose of neuroleptics prescribed fell and the proportion administered by depot injection increased. Since 1983, however, some of these favourable trends have been reversed. Prescribing practices may also vary between teaching and non-teaching hospitals.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 156 , Issue 6 , June 1990 , pp. 827 - 834
Copyright
Copyright © Royal College of Psychiatrists, 1990 

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.)

Article purchase

Temporarily unavailable

References

Baldessarini, R. J. & Davis, J. M. (1980) What is the best maintenance dose of neuroleptics in schizophrenia? Psychiatric Research, 3, 115–122.Google Scholar
Capstick, N. (1980) Long term fluphenazine decanoate maintenance dosage requirements of chronic schizophrenic patients. Acta Psychiatrica Scandinavica, 61, 246–262.Google Scholar
Carpenter, W. T., Heinrichs, D. W. & Hanlon, T. E. (1987) A comparative trial of pharmacologic strategies in schizophrenia. American Journal of Psychiatry, 144, 1466–1470.Google Scholar
Cheadle, A. J., Freeman, H. L. & Korrer, J. (1978) Chronic schizophrenic patients in the community. British Journal of Psychiatry, 132, 211–227.CrossRefGoogle Scholar
Chien, C. P. (1975) Drugs and rehabilitation in schizophrenia. In Drugs in Combination with Other Therapies (ed. M. Greenblatt), pp. 13–34. New York: Grune & Stratton.Google Scholar
Clarke, A. F. & Holden, N. L. (1987) The persistence of prescribing habits: a survey and follow-up of prescribing to chronic in-patients. British Journal of Psychiatry, 150, 88–91.Google Scholar
Curry, S. H., Marhshall, J. H. L., Davis, J. M., et al (1970) Chlorpromazine levels and effects. Archives of General Psychiatry, 22, 289–295.CrossRefGoogle ScholarPubMed
Dencker, S. J., Johansson, R. & Ludin, L. (1978) High doses of fluphenazine enanthate in schizophrenia. A controlled study. Acta Psychiatrica Scandinavica, 57, 405–414.Google Scholar
Edwards, S. & Kumar, V. (1984) A survey of prescribing of psychotropic drugs in a Birmingham psychiatric hospital. British Journal of Psychiatry, 145, 502–507.CrossRefGoogle Scholar
Herz, M. I. & Melville, C. (1980) Relapse in schizophrenia. American Journal of Psychiatry, 139, 801–805.Google Scholar
Herz, M. I., Szymanski, H. V. & Simon, J. C. (1982) Intermittent medication for stable schizophrenic outpatients: an alternative to maintenance medication. American Journal of Psychiatry, 139, 918–922.Google ScholarPubMed
Hogarty, G. E. (1984) Depot neuroleptics: the relevance of psychosocial factors - a United States perspective. Journal of Clinical Psychiatry, 45, 36–42.Google Scholar
Hogarty, G. E., Ulrich, R. & Goldberg, S. C. (1976) Sociotherapy and the prevention of relapse among schizophrenic patients. In Evaluation of Psychological Therapies (eds R. L. Spitzer & D. F. Klein), pp. 285–293. Baltimore: Johns Hopkins Press.Google Scholar
Hogarty, G. E., McEvoy, J. P., Munetz, M., et al (1988) Dose of fluphenazine, familial expressed emotion, and outcome in schizophrenia. Archives of General Psychiatry, 45, 797–805.Google Scholar
Holloway, F. (1988) Prescribing for the long-term mentally ill. A study of treatment practices. British Journal of Psychiatry, 152, 511–515.Google Scholar
Jelunek, T., Gardos, G. & Cole, J. O. (1981) Adverse effects of anti-parkinson drug withdrawal. American Journal of Psychiatry, 138, 1567–1571.Google Scholar
Johnson, D. A. W. (1973) The side-effects of fluphenazine decanoate. British Journal of Psychiatry, 123, 519–522.Google Scholar
Johnson, D. A. W. (1975) Observations on the dose regime of fluphenazine decanoate in maintenance therapy of schizophrenia. British Journal of Psychiatry, 126, 457–461.Google Scholar
Johnson, D. A. W. (1978) Prevalence and treatment of drug induced extrapyramidal symptoms. British Journal of Psychiatry, 132, 27–30.Google Scholar
Johnson, D. A. W. (1981) Studies of depressive symptoms in schizophrenia. British Journal of Psychiatry, 139, 89–101.CrossRefGoogle ScholarPubMed
Johnson, D. A. W. (1982) Depot injectable antipsychotic drugs. In Therapeutics Today (2) Haloperidol and the Treatment of Chronic Schizophrenia (ed. D. A. W. Johnson), pp. 12–31. Auckland: ADIS Press.Google Scholar
Johnson, D. A. W. (1983a) Is additional medication required in the maintenance treatment of schizophrenia. In Modern Trends in the Chemotherapy of Schizophrenia (ed. P. Hall), proceedings of the VII World Congress of Psychiatry, pp. 36–42. Copenhagen: Lundbeck.Google Scholar
Johnson, D. A. W. (1983b) Benzodiazepines in depression. In Benzodiazepines Divided (ed. M. R. Trimble), pp. 247–261. Chichester: John Wiley.Google Scholar
Johnson, D. A. W. (1984) Observations on the use of long-acting depot neuroleptic injections in the maintenance treatment of schizophrenia. Journal of Clinical Psychiatry, 45, 13–21.Google Scholar
Johnson, D. A. W. (1986) Depressive symptoms in schizophrenia: some observations on the frequency, morbidity and possible causes. In Contemporary Issues in Schizophrenia (eds A. Kerr & P. Snaith), pp. 451–459. London: Gaskell.Google Scholar
Johnson, D. A. W. (1988a) Observations on the use of depot neuroleptics in schizophrenia. In Psychopharmacology: Current Trends (eds D. E. Casey & A. V. Christensen), pp. 62–74. Berlin: Springer-Verlag.Google Scholar
Johnson, D. A. W. (1988b) The significance of depression in the prediction of relapse in chronic schizophrenia. British Journal of Psychiatry, 152, 320–323.Google Scholar
Johnson, D. A. W., Ludlow, J. M., Street, K., et al (1987) Double-blind comparison of half-dose and standard-dose flupenthixol decanoate in the maintenance treatment of stabilised outpatients with schizophrenia. British Journal of Psychiatry, 151, 634–638.CrossRefGoogle ScholarPubMed
Johnstone, E. C., Crow, T. J., Ferrier, I. N., et al (1983) Adverse effects of anticholinergic medication on positive schizophrenic symptoms. Psychological Medicine, 13, 513–527.Google Scholar
Jolley, A. G., Hirsch, S. R., McRink, A., et al (1989) Trial of brief intermittent neuroleptic prophylaxis for selected schizophrenic outpatients: clinical outcome at one year. British Medical Journal, 298, 985–990.Google Scholar
Kane, J. M., Rifkin, A., Woerner, M., et al (1983) Low dose neuroleptic treatment of out-patient schizophrenics: preliminary results for relapse rates. Archives of General Psychiatry, 40, 893–896.Google Scholar
Leff, J., Kuipers, L., Berkowitz, R., et al (1984) Psychosocial relevance and benefits of neuroleptic maintenance: experience in the United Kingdom. Journal of Clinical Psychiatry, 45, 43–49.Google Scholar
Lehmann, H. E., Wilson, W. H. & Deutch, M. (1983) Minimal maintenance medication: effects of three dose schedules on relapse rates and symptoms in chronic schizophrenic outpatients. Comprehensive Psychiatry, 24, 293–303.Google Scholar
Marder, S. R., Van Putten, T., Mintz, J., et at (1984) Costs and benefits of two doses of fluphenazine. Archives of General Psychiatry, 14, 1025–1029.Google Scholar
Marder, S. R., Van Putten, T., Mintz, J., et al (1987) Low and conventional dose maintenance therapy with fluphenazine decanoate: two year outcome. Archives of General Psychiatry, 44, 518–521.Google Scholar
McClelland, H. A., Blessed, G. & Bhater, S. (1974) The abrupt withdrawal of antiparkinsonian drugs in schizophrenic patients. British Journal of Psychiatry, 124, 151–159.Google Scholar
McClelland, H. A., Farquharson, R. G. & Leyburn, P. (1976) Very high dose fluphenazine decanoate. Archives of General Psychiatry, 33, 1435–1439.Google Scholar
McCreadie, R. G., Flanagan, W. L., McNight, J., et al (1979) High dose fluphenthixol decanoate in chronic schizophrenia. British Journal of Psychiatry, 135, 75–79.Google Scholar
Michel, K. & Kolakowska, T. (1981) A survey of prescribing psychotropic drugs in two psychiatric hospitals. British Journal of Psychiatry, 138, 217–221.Google Scholar
Morgan, R. & Gopalaswamy, A. K. (1984) Psychotropic drugs: another survey of prescribing patterns. British Journal of Psychiatry, 144, 298–302.Google Scholar
Muijen, M. & Silverstone, T. (1987) A comparative hospital survey of psychotropic drug prescribing. British Journal of Psychiatry, 150, 501–504.Google Scholar
Prusoff, B. A., Williams, D. H. & Weissman, M. M. (1979) Treatment of secondary depression in schizophrenia. Archives of General Psychiatry, 36, 569–575.Google Scholar
Quitkin, F., Rifkin, A. & Kaplan, J. H. (1975) Treatment of acute schizophrenia with ultra-high dose fluphenazine. Comprehensive Psychiatry, 16, 279–283.Google Scholar
Rifkin, A., Quitkin, F. & Carillo, A. (1971) Very high dose fluphenazine for non-chronic treatment refractory patients. Archives of General Psychiatry, 25, 398–403.Google Scholar
Rifkin, A., Quitkin, F. & Klein, D. F. (1975) Akinesia: a poorly recognised drug induced extrapyramidal behavioural disorder. Archives of General Psychiatry, 32, 672–674.Google Scholar
Rifkin, A., Quitkin, F. & Kane, J. (1978) Are prophylactic antiparkinson drugs necessary? A controlled study of procyclidine withdrawal. Archives of General Psychiatry, 35, 483–489.Google Scholar
Simpson, G. M., Amin, M. & Angus, J. W. S. (1972) Role of antidepressants and neuroleptics in the treatment of depression. Archives of General Psychiatry, 27, 337–345.Google Scholar
Simpson, G. M., Varga, E. & Haher, G. J. (1976) Psychotic exacerbations produced by neuroleptics. Diseases of the Nervous System, 37, 367–369.Google Scholar
Simpson, G. M., Cooper, T. B. & Bark, N. (1980) Effect of antiparkinsonian medication on plasma levels of chlorpromazine. Archives of General Psychiatry, 37, 205–208.Google Scholar
Siris, S. G., Adan, F., Cohen, M., et al (1987) Targeted treatment of depression like symptoms in schizophrenia. Psychopharmacology Bulletin, 23, 85–89.Google Scholar
Smith, R. C., Baumgartner, R. & Misra, C. H. (1984) Haloperidol: plasma levels and prolactin response as predictors of clinical improvement in schizophrenia: chemical v. radioreceptor plasma level assays. Archives of General Psychiatry, 41, 1044–1049.Google Scholar
Stahl, S. M. & Wets, K. M. (1988) Clinical pharmacology of schizophrenia. In Schizophrenia: The Main Issues (eds P. Bebbington & P. McGuffin), pp. 135–157. Oxford: Mental Health Foundation.Google Scholar
Van Putten, T. (1974) Why do schizophrenic patients refuse to take their drugs? Archives of General Psychiatry, 31, 67–72.Google Scholar
Van Putten, T. & May, P. R. A. (1978) Akinetic depression in schizophrenia. Archives of General Psychiatry, 35, 1101–1107.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.