Am J Psychiatry 1994; 151:35-39
Copyright © 1994 by American Psychiatric Association
Relation of plasma fluphenazine levels to treatment response and extrapyramidal side effects in first-episode schizophrenic patients
AR Koreen, J Lieberman, J Alvir, M Chakos, A Loebel, T Cooper and J Kane
Hillside Hospital Division of Long Island Jewish Medical Center, Albert Einstein College of Medicine, Glen Oaks, NY 11004.
OBJECTIVE: The aim of this study was to determine the relation between
plasma fluphenazine levels and clinical response in first-episode
schizophrenic patients. METHOD: Data from 36 first-episode schizophrenic or
schizoaffective inpatients diagnosed according to the Research Diagnostic
Criteria were evaluated. The patients received open, standardized treatment
with fluphenazine, 20 mg/day, for at least 4 weeks. Psychopathology was
assessed biweekly, and plasma fluphenazine levels were ascertained weekly.
Patients were classified as responders or nonresponders, and correlations
between their neuroleptic levels and ratings of psychopathologic and
extrapyramidal symptoms were computed. RESULTS: Plasma fluphenazine levels
for weeks 1 through 4 were significantly correlated with each other but
were not correlated with age, gender, diagnosis, or race. Mean neuroleptic
levels (weeks 3 and 4) were not different between responders and
nonresponders and were not correlated with measures of psychopathology or
extrapyramidal symptoms. CONCLUSIONS: These results do not indicate an
association between plasma fluphenazine levels and response to treatment or
extrapyramidal side effects in first-episode schizophrenia. The disparity
between the results of this study and those of previous studies may be due
to methodological differences or to a biologically based difference between
first-episode and chronic patients.
