The use of long-acting neuroleptics in the acute psychoses

Out of 120 inpatients treated with long-acting neuroleptics (LANs) between May 1977 and May 1978, the authors have selected 43 patients with clear-cut acute psychotic symptoms and high doses or frequent injections of fluphenazine decanoate: 19 schizophrenics, 13 schizoaffective psychoses and 11 manics. The average single dosage was 32 to 37 mg depending on the diagnostic category; the average weekly dosage was 45 to 55 mg; the average frequency of injections was one every 5 to 7 days. Drug combinations could be greater reduced. On discharge, all long-acting treatments were discontinued in manics, against some 60% of schizophrenics and schizoaffective psychoses. Among the advantages of LANs, the authors mention optimum pharmacokinetics (hence, lower doses), increased compliance from the part of the patient (less hostility thanks to decreased administrations than with oral medications), avoidance of cases of intestinal malabsorption, lowered financial burden (less treatment units, fewer admissions, shorter duration of hospitalization, less polypharmacy.