Fluphenazine Decanoate의 治療經驗 第3 篇 維體外路症狀과 經 口 用 抗精神病藥物의 治療經歷

CLINICAL EXPERIENCE OF FLUPHENAZINE DECANOATE： (III) INCIDENCE OF EXTRAPYRAMIDAL SIDE REACTION AND HISTORY OF ORAL ANTIPSYCHOTIC MEDICATION

The authors have tried to evaluate the incidence of extrapyramidal side reactions between acute schizophrenic and chronic schizophrenic groups in converting of oral antipsychotic medications into fluphenazine decanoate injection. The acute group consisted of 15 acute schizophrenics whose history of previous oral antipsychotic medication was less than 3 months. And the chronic group was 24 chronic schizophrenics whose history of、oral medication was more than one year. Ayd ’s method was applied to the all patients ; in converting of oral antipsychotics into the depot form, the full estimated dose of fluphenazine decanoate was given for the initial shot after two days of clearance of oral medications. DiMascio’s rating scale was used for evaluation of extrapyramidal symptoms. Extrapyram idal symptoms such as rigid facial expression, tremor, akinesia, rigidity, akathisia and dystonia were noticed to be 80 percent in the acute group and 45. 8 percent in the chronic group. This difference was significant on the level of 0.02. It was proved that the patient group vith a long-term history of previous oral antipsychotic medication revealed a lower incidence of extrapyramidal side reactions compared to the group with a shorter history of previous oral medication. For a safer dosage regimen even in the chronic patient group, however, it is recommended to start the regimen with very small test dose and to increase gradually up to lcc as required, because this low-dose regimen manifested extrapyramidal symptoms in 10 or 19 percent from the previous trials (Kim-1979，Kim & Kim-1980).