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. 2010 Jan;52(Suppl1):S317–S340. doi: 10.4103/0019-5545.69261

Table 2.

Efficacy studies of injectable depot antipsychotics in schizophrenia/psychosis

Authors Duration (in weeks) Sample size/scale/design Medication(s) and dose (s) in mg Outcome
Iyer et al.[30] 2 N = 30; Schiz, Open label Jenkin’s rating scale FFZ enanthate 12.5-62.5
  • Improvement (>50% reduction on Jenkin’s rating scale)

  • Out of 28 subjects, 18 improved

  • Drug had maximum effect on symptoms of withdrawal, guarding, cooperation, mannerisms, hallucinations, motivation and post-hospitalization goals

  • Physical, anxiety and depressive symptoms had not responded

Bagadia et al.[31] 4 N = 50; Schiz, Open label FFP Decanoate 25-150 mg/month
  • 78% of the subjects improved (6% completely improved, 38% markedly improved, 34% moderately improved)

  • All subtypes of schizophrenia including the chronic undifferentiated type showed good response

  • Subjects with poor prognosis had 80% improvement

  • Shorter duration of illness seems to have been benefited the most

  • Paranoid delusion, auditory hallucination, excitement and apathy responded best to the drug

  • Follow-up was done for 8 weeks after one month of drug trial was over

Bagadia et al.[32] 4 weeks to 6 months N = 40; (Chronic Schiz) and N = 78; (schiz) FFZ Decanoate Total dose 50-500mg
  • Of 26 subjects of chronic schizophrenia, who completed trial for 4 weeks, 20 showed significant improvement

  • 66 (84.6%) of the subjects who took treatment for 1 to 6 months classified as good prognosis schizophrenia improved significantly

Jha and Bhaskaran[33] Duration not mentioned (7 to 54 injections) N = 112; Schizophrenia, Open trial FFZ 25 mg/week
  • 3.6% of the subjects recovered, 3.6% had marked improvement, 25% were rated as improved, 22.3% were rated as manageable, there was no change in 41.8% of subjects, while 1.8% each worsened and discontinued treatment and 0.9% of subjects died

  • Of the 28 subjects who improved, 4 subjects continued to develop psychotic symptoms periodically despite being under medication while 9 subjects showed relapse

  • Paranoid type of schizophrenia responded best while hebephrenic type responded least

  • Symptoms which worsened were depression, guilt feelings and agitation

  • FFZ was found to be costlier than CPZ, when costs of antiparkinsonian medication was combined with that of FFZ

Gehlot et al.[34] 20 N = 30; Schiz (Subjects who had not responded to oral phenothiazines, butyrophenones, ECT, relapsed or had non-compliance) FFP decanoate25 mg/2-3 weekly
  • 60%subjects responded favorably

  • Symptoms which improved-formal thought disorder, ideas of reference and control, delusion of persecution, grandeur and infidelity, disturbance of affect e.g. inappropriate affect, apathy, irritability), auditory hallucinations, uncooperativeness, aggressiveness, and impulsive behavior, poor self care

  • Symptoms which had not responded included- mutism, mannerism, lack of initiative, muttering, hypochondriasis, severe preoccupation, silly giggling

Bagadia et al.[35] 3 months N = 27; Schiz, Open trial, BPRS Pipothiazine palmitate 50 mg/weekly
  • 76% of the subjects showed significant improvement at end of 1 month; further significant improvement occurred between 1 and 3 months.

Bagadia[36] 4 months N = 83; ICD-8 Schiz, BPRS, social adjustment scale, work efficiency evaluation scale FFP Decanoate started at 6.25/week increased weekly vs. CPZ/TFP
  • 54% of the subjects made >50% of the expected visits

  • 83% of the subjects improved on BPRS, 85% on social adjustment scale and 94% on work efficiency evaluation scale

Shukla[37] 1-3 year N = 65; Chronic Schiz patients with frequent relapses despite treatment with neuroleptics and/or ECT FFP Decanoate 25 mg/3 week
  • FFP was found to be effective in 25 (62.5%) of the subjects who completed the trial

  • Response was better in patients with onset of illness after 20 years of age, illness duration 2-5 years, with a diagnosis of paranoid and undifferentiated subtype, followed by catatonic subtype

  • Patients with hebephrenic and simple subtype showed poorer response

Varma and Kulhara[38] 24 (Maintenance phase) N = 33; DSM-III Schiz, Open trial, BPRS, SANS, CGI, AIMS, DOTES, ESRS HPL Decanoate 50-300/4 week
  • At the end of the study period, 20 subjects had shown much improvement and 10 had minimally improved

  • Significant reduction in severity of illness score was noted from the 8th week onwards

  • Significant improvement on CGI was observed from the 4th week onwards

  • Significant reduction in BPRS scores was noted from the 2nd week onwards

  • There was significant reduction in the SANS score

Schiz - Schizophrenia; FFZ - Fluphenazine enanthate; FFP - Fluphenazine decanoate; ECT - Electroconvulsive therapy; BPRS - Brief psychiatric rating scale; CPZ - Chlorpromazine; TFP - Trifluoperazine; SANS - Scale for assessment of negative symptoms; CGI - Clinical global impression scale; AIMS - Abnormal involuntary movement scale; DOTES - Dosage record and treatment emergent symptom scale; ESRS - Extrapyramidal symptoms rating scale