Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The evolution of 28 patients displaying acute forms of psychoses (schizophrenia, mania, exacerbation of psychosis in chronic cases) was studied under the treatment with Acuphase Acetate continued with Clopixol Depot. In both therapies a tioxantenic neuroleptic is involved for the acute form of the illness (Acuphase) and for the maintenance treatment (Clopixol Depot). The assessment of the results was carried out on individual observation files using Global Rating Scale (G.R.S.), B.P.R.S. and paraclinical measurement to appreciate the biological tolerance. Favourable effects of treatment were evident in the first 4 days and in six cases even within the first 24 hours. The whole group of patients showed a significant decrease of morbidity evolving from a high severity to a medium and reduced one. The biological tolerance was very good, 6 to 12 months' care.
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PMID:Open clinical study of Clopixol-Acuphase (zuclopenthixol acetate) treatment followed by Clopixol Depot in acute psychoses with long-term course tendency. 168 11

We carried out a 9-day double-blind clinical trial comparing intramuscular zuclopenthixol acetate with liquid oral haloperidol in the treatment of 40 newly admitted schizophrenic patients with acute exacerbation. A parallel-group design was used with stratification by sex. Zuclopenthixol acetate (50 to 150 mg) was given intramuscularly every 3 days, whereas liquid haloperidol (10 to 30 mg daily) was given orally three times a day, with supplementary doses of each medication given under double-blind conditions when needed for agitation. No other sedative drugs, including benzodiazepines, were administered. The mean daily dose was 18.9 mg for haloperidol as compared with a mean dose per 3 days of 117.6 mg for zuclopenthixol. The two treatments were found to be equally efficacious on the Brief Psychiatric Rating Scale and Clinical Global Impression Scale. Both drugs induced similar extrapyramidal side effects. However, more tremors were associated with zuclopenthixol as was a tendency for tardive dyskinesia to be unmasked at the end of the injection interval. Sedation was higher with zuclopenthixol acetate than with haloperidol. Serum creatinine phosphokinase levels were not significantly increased after zuclopenthixol injections. The results of this trial suggest that zuclopenthixol acetate given intramuscularly every second to third day offers an alternative to conventional liquid oral haloperidol in the management of acute schizophrenia.
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PMID:A double-blind controlled study of intramuscular zuclopenthixol acetate and liquid oral haloperidol in the treatment of schizophrenic patients with acute exacerbation. 788 17

In retrospective research--frequency of aggression among the patients admitted to the Department of Psychiatry in Wroclaw in 1992 was estimated about 8.2% from all the patients. Aggressive events were more frequent among the female patients. The most common group of drugs used in order to settle down the patients was benzodiazepines regardless of origin of aggression. In terms of type of disorder aggression was more likely to occur in schizophrenia, then Clopixol-acuphase was used as the most effective drug. Restraining was one of the unavoidable method in several cases but as the only one method it was used in 13% of cases.
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PMID:[Medical procedure with aggressive patients: experiences of psychiatric clinic in Wroclaw]. 790 91

The first scale evaluating psychotic anxiety specifically is the "Psychotic Anxiety Scale": PAS was proposed and validated by O. Blin et al. in 1988. Zuclopenthixol acetate formulation is a both rapid and middle prolonged (2-3 days) acting neuroleptic used to start the treatment in an acute episode of the psychotic illness. It has been established as an effective drug for a broad spectrum of symptoms in schizophrenia and other psychosis, but its "angolytic" effect had never been quantified. It was interesting to study the efficacy of zuclopenthixol acetate on psychotic anxiety with PAS during the first 9 days of hospitalisation of psychotic patients. During the study, the clinical evaluation was made with the Psychotic Anxiety Scale (PAS) for the main criteria; Clinical Global Impression (CGI) and the Nordic side effect scale (UKU) for the secondary criteria. Assessments were performed at days, 0, 1, 3, 4, 6, 7 and 9. Zuclopenthixol acetate was administered at Day 0, Day 3, and Day 6. Protocol allowed an additional injection at D1 in case of insufficient efficacy. Forty six patients were included into this open non comparative multicenter study: 23 patients were male and 23 female. Their mean age (X +/- S) was 32 +/- 10 years, and according to DSM III-R, 28 of them got schizophrenia diagnosis, 13 suffered from brief psychotic disorder and 3 from schizophreniform disorder (diagnosis was missing for two subjects). The mean dosage of zuclopenthixol acetate by injection, foreseen in the protocol, was between 126 to 138 mg. Four patients were treated with high dose: more than 800 mg during the 9 days of the study and 6 patients had 5 injections or more. Between D0 and D9, the total PAS score decreased from 63 (from moderated to severe anxiety) to 25 (absence of anxiety) and the reduction of score was statistically significant from 24 hours after the first injection (p < 0.01). Various items analysis of PAS has showed a statistically significant reduction from 24 hours for all items (p < 0.01) except for physical depersonalisation, inhibition of thought and motor inhibition. Assessment index of therapeutic effect (CGI 2) decreased in a statistically significant way from 72 hours (p = 0.01). Globally, we found a good correlation between Clinical Global Impression and PAS, it was maximal and significant at day 7 (r = 0.87). According to the UKU scale and the investigators, the treatment was well tolerated. The results suggest that zuclopenthixol acetate is an effective and reliable way to initiate neuroleptic treatment with an statistically significant activity in psychotic anxiety from 24 hours.
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PMID:[Efficacy of zuclopenthixol acetate on psychotic anxiety evaluated in an open study]. 903 83

Zuclopenthixol acetate is a rapid-acting, injectable neuroleptic drug with a duration of action that allows for administration once every 2 to 3 days, in contrast to injectable haloperidol, which may require administration more than once daily. To assess the place of zuclopenthixol acetate in the treatment of acute episodes of schizophrenia, a cost-consequence analysis was performed comparing this new medication with short-acting, injectable haloperidol. The perspective of the Quebec health care system was adopted. The study population comprised patients diagnosed with schizophrenia who experienced an acute episode of psychosis and who were treated with intramuscular (i.m.) haloperidol. The study assessed patients for 9 days after the start of treatment. The literature was the principal source of comparative data about the clinical outcomes of the two treatments. The total cost associated with zuclopenthixol acetate i.m. or haloperidol i.m. was modeled using a decision tree built around the number of i.m. injections required to achieve stabilization. To establish costs, expert panels were consulted and patients' files were reviewed for a sample of schizophrenic patients who had been hospitalized in a large psychiatric or general hospital subsequent to a visit to the emergency department and had received a short-acting i.m. neuroleptic drug. Only a direct medical records costs were considered. Because zuclopenthixol acetate was not on the market at the time of the study, the file review did not allow for a direct estimate of its related costs but did provide an account of haloperidol use. The literature shows that zuclopenthixol acetate is similar to haloperidol with respect to the control of psychotic episodes; however, zuclopenthixol acetate is associated with increased sedation and a lower incidence of extrapyramidal symptoms. Using the base-case estimate for the number of injections required for stabilization, the incremental cost of zuclopenthixol acetate 50 mg over haloperidol was $25.00 (1995 Canadian dollars) per patient at the psychiatric hospital and $21.00 per patient at the general hospital. The results were sensitive to the estimate of the number of injections and the number of minutes of nursing care required by agitated patients. Zuclopenthixol acetate resulted in cost savings over haloperidol if it permits a reduction of 25% in minutes of nursing care or if 85% of patients require 2 injections or less (45% requiring 1 injection and 40% requiring 2). However, whichever drug is used, the cost of the injectable neuroleptic represents a small fraction of the cost of care for acutely psychotic patients.
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PMID:Economic evaluation of zuclopenthixol acetate compared with injectable haloperidol in schizophrenic patients with acute psychosis. 915 70

The aim of this study was to evaluate the efficacy and side effects of zuclopenthixol acetate compared with haloperidol in the management of the acutely disturbed schizophrenic patient. Suitable subjects diagnosed as having schizophreniform disorder or acute exacerbation of schizophrenia admitted to the psychiatric wards Hospital Kuala Lumpur were randomised to receive either zuclopenthixol acetate or haloperidol. They were rated blind for three consecutive days using the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI) and UKU Side Effects Scale. Apart from repeat injections of the same medication, no other anti-psychotic was given for the duration of the study. 50 subjects entered the study of which 44 completed. 23 were given zuclopenthixol acetate and 21 haloperidol. Both groups significantly reduced BPRS and CGI scores on all 3 days compared to the initial rating (p < 0.001). There was however no difference between the zuclopenthixol acetate and haloperidol group scores on all days (p > 0.05). More subjects on haloperidol than zuclopenthixol required more than 1 injection during the study. Both groups had minimal side effects. Zuclopenthixol acetate was effective in the management of the acutely disturbed schizophrenic.
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PMID:A double blind comparison of zuclopenthixol acetate with haloperidol in the management of acutely disturbed schizophrenics. 1097 79

Zuclopenthixol and haloperidol are antipsychotic medications displaying different galenic forms, while risperidone is available on the market only in tablet form. The depot form presents advantages; the duration of action allows 3-4 weeks between administrations. A meta-analysis showed that zuclopenthixol patients had a higher response rate than haloperidol. A Markov model was developed to estimate the cost-effectiveness of the three antipsychotics in schizophrenia over a 5-year period. Model parameter estimates were based on a meta-analysis and literature. The viewpoint was that of the French National Health Insurance. When compared to haloperidol and risperidone, zuclopenthixol patients had additional 4 and 7 months without relapse correspondingly over a 5-year period. The estimated 5-year medical cost associated with zuclopenthixol was 800 and 1100 euros less than haloperidol and risperidone, respectively, per patient. Sensitivity analyses indicated that the results were robust to changes in key variables. The model indicates that the zuclopenthixol treatment strategy dominates haloperidol and risperidone.
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PMID:A pharmacoeconomic evaluation of zuclopenthixol compared with haloperidol and risperidone in the treatment of schizophrenia. 1560 42

The aim of this study was to evaluate psychopharmacological treatment and the length of stay (LOS) of patients with schizophrenia in a maximum-security psychiatric unit. Data were collected from the hospital files of 82 consecutively admitted patients with schizophrenia who were both admitted and discharged between the years 1987 and 2000. Psychotropic medication and LOS at the time of discharge were registered. Ninety-five per cent of the patients received antipsychotic medication. Zuclopenthixol was the most frequent medication, given to 43% of the patients. Antipsychotic polypharmacy was found in 20% of the cases. Twenty-seven per cent of the patients were medicated with doses above the recommended therapeutic dose range. During the study period, there was no change in the administration and number of psychotropics, but there was an increase in the dosage of antipsychotics. However, LOS was unchanged during the same time. This supports other findings, which suggest that there is no clinical benefit of higher antipsychotic dosage. It is suggested that an optimized medication practice could yield beneficiary effects, not only for schizophrenic symptoms, but also for violence in schizophrenic patients.
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PMID:Antipsychotic medication and length of stay at a psychiatric maximum-security unit in Norway (1987-2000). 1663 32