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Flupenthixol treatment for cocaine abusers with schizophrenia: a pilot study
F R Levin1, S M Evans, S Coomaraswammy
1New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York 10032, USA.
The American Journal of Drug and Alcohol Abuse
|September 19, 1998
Summary
Flupenthixol (FLX) shows promise in treating individuals with schizophrenia and cocaine abuse. This study found FLX improved psychiatric symptoms and reduced cocaine use in a pilot group.
Area of Science:
- Psychiatry
- Addiction Medicine
- Clinical Pharmacology
Background:
- Cocaine use is prevalent in schizophrenia patients (15-60%).
- Patients may use cocaine to alleviate anhedonia or neuroleptic side effects.
- Flupenthixol (FLX) is a neuroleptic with potential for treating cocaine abuse.
Purpose of the Study:
- To evaluate the efficacy of Flupenthixol (FLX) in dually diagnosed patients with schizophrenia and cocaine abuse.
- To assess the impact of FLX on psychiatric symptoms, cocaine use, and treatment adherence.
Main Methods:
- An open pilot study with 8 participants over 10 weeks (4 inpatient, 6 outpatient).
- Participants were switched to FLX (40 mg decanoate every 2 weeks) after neuroleptic cross-tapering.
- Psychiatric symptoms (PANSS, BDI), side effects (Simpson NRS, AIMS), and urine toxicology were assessed weekly.
Main Results:
- Significant reductions in positive (31%) and negative (29%) symptoms on the PANSS.
- A 57% decrease in Beck Depression Inventory (BDI) scores.
- Cocaine-positive urines decreased by 28% (over 75% reduction for most patients), and missed clinic visits decreased by 26%.
Conclusions:
- Flupenthixol (FLX) was well-tolerated in schizophrenic cocaine abusers.
- FLX demonstrated potential for improving psychiatric symptomatology and reducing cocaine use in this population.
- Further research is warranted to confirm FLX's utility in treating dual diagnosis.