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Depot antipsychotics revisited

Published online by Cambridge University Press:  02 January 2018

David Taylor
David Taylor*
Affiliation:
Maudsley Hospital, Denmark Hill, London SE5 8AZ
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Many typical antipsychotic drugs may be manufactured as alcohols, which react with carboxylic acids to form esters (organic salts). These compounds are highly oil-soluble, but are only sparingly soluble in aqueous fluids such as blood. Thus, an oily solution of an antipsychotic can be injected into a muscle, where it forms a reservoir or ‘depot’ of drug that is slowly dissolved in the surrounding blood. Once released into the blood, drug esters are rapidly hydrolysed by endogenous esterase enzymes to produce the parent antipsychotic. Stable serum concentrations of antipsychotics are usually engendered (although this is not always observed in practice (Tuninger & Levander, 1996)), and administration need only take place every few weeks or so. Adherence can be assured and relapse rates are reduced (Groves & Mandel, 1975: Davis et al, 1994).

Type
Drug Information Quarterly
Information
Psychiatric Bulletin , Volume 23 , Issue 9: The Journal of Trends in Psychiatric Practice , September 1999 , pp. 551 - 553
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 1999 The Royal College of Psychiatrists

References

Amdisen, A., Aaes-Joergensen, T., Thomsen, N. J., et al (1986) Serum concentrations and clinical effect of zuclopenthixol in acutely disturbed, psychotic patients treated with zuclopenthixol acetate in ‘Viscoleo’®. Psychopharmacology, 90, 412 416.Google Scholar
Association of British Pharmaceutical Industry (1996) Compendium of Data Sheets and Summaries of Product Characteristics 1996/97. London: Datapharm Publications.Google Scholar
Ayd, F. J. Jr (1975) The depot fluphenazines: a reappraisal after 10 years' clinical experience. American Journal of Psychiatry, 132, 491 500.Google ScholarPubMed
Beresford, R. & Ward, A. (1987) Haloperidol decanoate: a preliminary review of its pharmacodynamic and pharmacokinetic properties and therapeutic use in psychosis. Drugs 33, 31 49.Google Scholar
Carney, M. W. P. & Sheffield, B. F. (1976) Comparison of antipsychotic depot injections in the maintenance treatment of schizophrenia. British Journal of Psychiatry, 128, 476 481.Google Scholar
Chakravarti, S. K., Muthu, A., Muthu, P. K., et al (1990) Zuclopenthixol acetate (5% in ‘Viscoleo’): single-dose treatment for acutely disturbed psychotic patients. Current Medical Research and Opinion, 12, 58 65.Google Scholar
Coutinho, E., Fenton, M., Campbell, C., et al (1997). Details of studies of zuclopenthixol acetate are needed. British Medical Journal 315, 884.Google Scholar
Currey, S. H., Whelpton, R., de Schepper, P. J., et al (1979) Kinetics of fluphenazine after fluphenazine dihydrochloride, enanthate and decanoate administration to man. British Journal of Clinical Pharmacology, 7, 325 331.CrossRefGoogle Scholar
Davis, J. M., Matalon, L., Watanabe, M. D., et al (1994) Depot antipsychotic drugs: place in therapy. Drugs, 47, 741 773.Google Scholar
Dom, R., De Mesmaecker, M., van den Broucke, T., et al (1978) Maintenance treatment of chronic schizophrenic patients: a study with the long-acting thioxanthene derivative, cis(Z)-clopenthixol decanoate–sordinol® depot. Acta Psychiatrica Scandinavica, 57, 299 304.Google Scholar
Ereshefsky, L., Saklad, S. R., Jann, M. W., et al (1984) Future of depot neuroleptic therapy: pharmacokinetic and pharmacodynamic approaches. Journal of Clinical Psychiatry, 45, 50.Google Scholar
Girard, M., Granier, F., Schmitt, L., et al (1984) Initial results of a pharmacokinetic study of pipothiazine and its palmitic ester. (Piportil L4) in a schizophrenic population. Encéphale, 10, 171 176.Google Scholar
Groves, J. E. & Mandel, M. R. (1975) The long-acting phenothiazines. Archives of General Psychiatry, 32, 893 900.Google Scholar
Hay, J. (1995) Complications at site of injection of depot neuroleptics. British Medical Journal, 311, 421.Google Scholar
Jørgensen, A. (1978) Pharmacokinetic studies on flupenthixol decanoate, a depot neuroleptic of the thioxanthene group. Drug Metabolism Reviews, 8, 235 249.Google Scholar
Marr, W. & Batchelor, D. (1982) Haloperidol decanoate: major progress with antipsychotic therapy. Clinical Research Reviews, 2, 61 79.Google Scholar
Nyberg, S., Farde, L., Halldin, C., et al (1995) D2 dopamine receptor occupancy during low-dose treatment with haloperidol decanoate. American Journal of Psychiatry, 152, 173 178.Google ScholarPubMed
Reynolds, J. E. F. (1996) Martindale – The Extra Pharmacopoeia (31st edn). London: Royal Pharmaceutical Society of Great Britain.Google Scholar
Reyntjens, A. J. M., Heykants, J. J. P., Woestenborghs, R. J. H., et al (1982) Pharmacokinetics of haloperidol decanoate: a two-year follow-up. International Pharmacopsychiatry, 17, 238 246.Google Scholar
Taylor, D. (1997) Switching from typical to atypical antipsychotics: practical guidelines. CNS Drugs, 8, 285 292.Google Scholar
Tuninger, E. & Levander, S. (1996) Large variations of plasma levels during maintenance treatment with depot neuroleptics. British Journal of Psychiatry, 168, 618 621.Google Scholar
Van Praag, H. M. & Dols, L. C. W. (1973) Fluphenazine enanthate and fluphenazine decanoate: a comparison of their duration of action and motor side effects. American Journal of Psychiatry, 130, 801 804.Google Scholar
Warner, A. M. & Wyman, S. M. (1975) Delayed severe extrapyramidal disturbance following frequent depot phenothiazine administration. American Journal of Psychiatry, 132, 743 745.Google ScholarPubMed
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