Hostname: page-component-5cf477f64f-bmd9x Total loading time: 0 Render date: 2025-04-08T01:22:43.606Z Has data issue: false hasContentIssue false
  • English
  • Français

The Use of High-Dose Antipsychotic Medication

Published online by Cambridge University Press:  02 January 2018

C. Thompson
C. Thompson*
Affiliation:
Royal South Hants Hospital, Southampton S09 4PE
Get access Rights & Permissions [Opens in a new window]

Extract

Antipsychotic medication is the mainstay of treatment for the functional psychotic illnesses. Such drugs are also referred to as neuroleptics (meaning a drug with both antipsychotic effects and effects on movement) and major tranquillisers. The psychotic illnesses for which they are prescribed include schizophrenia, mania in the course of a bipolar mood disorder, and, more rarely, depression accompanied by psychotic symptoms. These are not uncommon illnesses. At some time during their lives approximately 1% of the population will suffer at least one episode of schizophrenia and a further 1% will suffer at least one episode of mania. During an episode some patients, but by no means all, suffer extreme changes in their thinking, mood and behaviour which can be very distressing to experience and which can make patients a danger to themselves or other people.

Type
Consensus Statement
Information
The British Journal of Psychiatry , Volume 164 , Issue 4 , April 1994 , pp. 448 - 458
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

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.)

References

Baldessarini, R. J., Cohen, B. M. & Teicher, M. H. (1988) Significance of neuroleptic dose and plasma level in the pharmacological treatment of psychoses. Archives of General Psychiatry, 45, 79–90.CrossRefGoogle ScholarPubMed
Baldessarini, R. J., & Frankenburg, F. R. (1991) Clozapine, a novel antipsychotic agent. New England Journal of Medicine, 324, 746–754.Google Scholar
Barnes, T. R. E. & Bridges, P. K. (1980) Disturbed behaviour induced with high dose antipsychotic drugs. British Medical Journal, 281, 274–275.Google Scholar
Bjorndal, E., Bjerre, M., Gerlach, J., et al (1980) High dose haloperidol therapy in chronic schizophrenic patients. A double-blind study of clinical response, side effects, serum haloperidol and serum prolactin. Psychopharmacology, 67, 17–23.Google Scholar
Cookson, I. B. (1987) The effects of a 50% reduction of cis(z)-fluphenthixol decanoate in chronic schizophrenic patients maintained on a high dose regime. International Clinical Psychopharmacology, 2, 141–149.CrossRefGoogle Scholar
Cookson, I. B., Muthu, M. S., George, A., et al (1983) High dose neuroleptic treatment of chronic schizophrenic patients. Research Communications in Psychology and Behaviour, 4, 305–316.Google Scholar
Committee on the Safety of Medicine (1990) Cardiotoxic effects of pimozide. Current Problems, No. 29.Google Scholar
Dencker, S. J., Johansson, R., Lundin, L., et al (1978) High doses of fluphenazine enanthate in schizophrenia: a controlled study. Acta Psychiatrica Scandinavica, 57, 405–414.Google Scholar
Department of Health (1990) Code of Practice of the Mental Health Act 1983. London: HMSO.Google Scholar
Department of Health (1991) Personal social services: provision for people with mental illness in England 1980–90. Department of Health Statistical Bulletin, 3, 91.Google Scholar
Dietch, J. T. & Jennings, R. K. (1988) Aggressive dyscontrol in patients treated with benzodiazepines. Journal of Clinical Psychiatry, 49, 184–188.Google Scholar
Drug and Therapeutics Bulletin (1991) Management of behavioural emergencies. Drug and Therapeutics Bulletin, 29, 62–64.CrossRefGoogle Scholar
Drug and Therapeutics Bulletin (1992) Prescribing for unlicensed drugs or using drugs for unlicensed indications. Drug and Therapeutic Bulletin, 30, 97–99.CrossRefGoogle Scholar
Einfeld, S. (1990) Guidelines for the use of psychotropic medication in individuals with learning disability. Australian and New Zealand Journal of Developmental Disabilities, 16, 71–73.Google Scholar
Farde, L., Nordstrom, A. L., Wiesel, F. A., et al (1992) Positron emission tomographic analysis of central D1 and D2 dopamine receptor occupancy in patients treated with classical neuroleptics and clozapine. Archives of General Psychiatry, 49, 538–544.Google Scholar
Gardos, G., Cole, J. O. & Orzack, M. H. (1973) The importance of dosage in antidepressant drug administration, a review of dose-response studies. Psychopharmacologia, 29, 221–230.Google Scholar
Goldney, R. D., Spence, N. D. & Bowes, J. A. (1986) The safe use of high dose neuroleptics in a psychiatric intensive care unit. Australian and New Zealand Journal of Psychiatry, 20, 370–375.Google Scholar
Herrera, J. N., Sramek, J. J., Costa, J. F., et al (1988) High potency neuroleptics and violence in schizophrenia. Journal of Nervous and Mental Disease, 176, 558–561.CrossRefGoogle Scholar
Hirsch, S. R. & Barnes, T. R. E. (1994) Clinical use of high-dose neuroleptics. British Journal of Psychiatry, 164, 94–96.CrossRefGoogle ScholarPubMed
Itil, T., Keskiner, A., Heinemann, L., et al (1970) Treatment of resistant schizophrenics with extreme high dose fluphenazine hydrochloride. Psychosomatics, 11, 456–463.Google Scholar
Kane, J. M. (1987) Treatment of schizophrenia. Schizophrenia Bulletin, 13, 133–156.Google Scholar
Kane, J. M., Honigfeld, G., Singer, J., et al (1988) Clozapine for the treatment resistant schizophrenic: a double blind comparison with chkxpromazine. Archives of General Psychiatry, 45, 789–796.CrossRefGoogle Scholar
Little, K. Y., Gay, T. L. & Vore, M. (1989) Predictors of response to high dose antipsychotics in chronic schizophrenics. Psychiatry Research, 30, 1–9.Google Scholar
McClelland, H. A., Farquharson, R. G., Leyburn, P., et al (1976) Very high dose fluphenazine decanoate: a controlled trial in chronic schizophrenia. Archives of General Psychiatry, 33, 1435–1439.Google Scholar
McCreadie, R. G. & MacDonald, I. M. (1977) High dose haloperidol in chronic schizophrenia. British Journal of Psychiatry, 131, 310–316.Google Scholar
McCreadie, R. G., Flanagan, W. L., McKnight, J., et al (1979) High dose flupenthixol decanoate in chronic schizophrenia. British Journal of Psychiatry, 135, 175–179.Google Scholar
Mehtonen, O.-P., Aranko, K., Malkonen, L., et al (1991) A study of sudden death associated with the use of antipsychotic or antidepressant drugs. Acta Psychiatrica Scandinavica, 84, 58–64.CrossRefGoogle ScholarPubMed
Pilowsky, L. S., Ring, H., Shrine, P. J., et al (1992a) Rapid transquillisation, a survey of emergency prescribing in a general psychiatric hospital. British Journal of Psychiatry, 160, 831–835.CrossRefGoogle Scholar
Pilowsky, L. S., Costa, D. C., Ell, P. J., et al (1992b) Clozapine, single photon emission tomography and the D2 dopamine receptor blockade hypothesis of schizophrenia. Lancet, 340, 199–202.Google Scholar
Prien, R. F. & Cole, J. O. (1968) High dose chlorpromazine therapy in chronic schizophrenia. Archives of General Psychiatry, 18, 482–495.Google Scholar
Quitkin, F., Rifkin, A. & Klein, D. F. (1975) Very high dosage vs standard dosage fluphenazine in schizophrenia. Archives of General Psychiatry, 32, 1276–1281.Google Scholar
Royal Australian and New Zealand College of Psychiatrists (1991) Practice guidelines number 4. General Statement Concerning the Use of Medication Dosages Outside Normal Clinical Practice. Practice Guideline No. 4. Sydney: Royal Australian and New Zealand College of Psychiatrists.Google Scholar
Simpson, G. M., Davis, J., Jefferson, J. W., et al (1987) Sudden deaths in psychiatric patients: the role of neuroleptic drugs. American Psychiatric Association task force report, 27. Washington, DC: APA.Google Scholar
Taylor, P. J. & Fleminger, J. J. (1980) ECT and schizophrenia. Lancet, i, 1380–1382.Google Scholar
Wolkin, A., Barouche, F., Wolfe, A. P., et al (1989a) Dopamine receptor blockade and clinical response: evidence for two biological subgroups of schizophrenia. American Journal of Psychiatry, 146, 905–908.Google Scholar
Wolkin, A., Brodie, J. D., Barouche, F., et al (1989b) Dopamine receptor occupancy and plasma haloperidol levels. Archives of General Psychiatry, 46, 482–483.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.