Fluspirilene neuroleptic depot injections and indurations

Local reactions at injection sites have limited the use of depot fluspirilene, an otherwise effective treatment for chronic schizophrenia. Thirty-nine reports of fluspirilene-treated patients were analyzed and the patients were examined for indurations. It was found that patients with indurations were given significantly higher doses and volumes of the drug. The mean number of high volume injections (over 3ml) at each site was the most significant differentiating factor between the two groups: 19 such injections over a twelve month period for those with indurations, as compared to 3 for those without. None of the following variables were significant; age, sex, allergies, or total length of time on the drug. Previous administration of other forms of depot neuroleptics did not differentiate the two groups. Biopsy showed serous atrophy of subcutaneous fat, prominent blood vessels and hemosiderin laden macrophages.