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Persistence of Extra-pyramidal Disorders and Psychiatric Relapse after Withdrawal of Long-Term Phenothiazine Therapy

Published online by Cambridge University Press:  29 January 2018

H. I. Hershon ,
P. F. Kennedy  and
R. J. Mcguire
H. I. Hershon
Affiliation:
Addiction Research Unit, Institute of Psychiatry, Denmark Hill, London S.E.5
P. F. Kennedy
Affiliation:
University Department of Psychiatry, Edinburgh
R. J. Mcguire
Affiliation:
University Department of Psychiatry, Edinburgh
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Extract

It has been said that any drug which is active and produces an effect which is beneficial must also, under similar or different circumstances, have side-effects which are neither beneficial nor desired (Hamilton, 1965). It is the balance between desired and undesired actions which determines the usefulness of any drug. Such a balance varies according to the individual patient's needs. Thus a life-saving drug will be given even if it has serious side effects, while this would not be justifiable for a drug with only a marginally therapeutic effect. Scrutiny of past results may enable clinicians to make finer predictions as to which patient will benefit from a certain drug and which will suffer unacceptable side-effects. Phenothiazines are one group of drugs whose efficacies and dangers have been discussed in this way.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 120 , Issue 554 , January 1972 , pp. 41 - 50
Copyright
Copyright © Royal College of Psychiatrists, 1972 

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References

Abenson, M. H. (1969). ‘Drug withdrawal in male and female chronic schizophrenics.’ Brit. J. Psychiat., 115, 961–2.Google Scholar
Ayd, F. J. (1961). ‘A survey of drug-induced extrapyramidal reactions.’ J.A.M.A., 175, 1054–60.Google Scholar
Blackburn, H. L., and Allen, J. L. (1961). ‘Behavioural effects of interrupting and resuming tranquillizing medication among schizophrenics.’ J. nerv. ment. Dis., 1335, 303–8.Google Scholar
Brandon, S., McClelland, H. A., and Protheroe, C. (1971). ‘A study of facial dyskinesia in a mental hospital population.’ Brit. J. Psychiat., 118, 171–84.Google Scholar
Cawley, R. H. (1967). ‘The present status of physical methods of treatment of schizophrenia.’ In Recent Development in Schizophrenia. Ed. Coppen, A., and Walk, A. Brit. J. Psychiat., Special Publication No. 1.Google Scholar
Chien, C. P., and Dimascia, A. (1967). ‘Drug-induced extra-pyramidal symptoms and their relations to clinical efficacy.’ Amer. J. Psychiat., 123, 1490–98.Google Scholar
Crane, G. E. (1968). ‘Tardive dyskinesia in patients treated with major neuroleptics: a review of the literature.’ Amer. J. Psychiat., 124, Suppl., 40–48.Google Scholar
Crane, G. E., Ruiz, P., Kernohan, W. J., Wilson, W., and Royalty, N. (1969). ‘Effects of drug withdrawal on tardive dyskinesia.’ Activitas Nervosa Superior (Praha), 11, 30–5.Google Scholar
Demars, J. P. C. A. (1966). ‘Neuromuscular effects of long-term phenothiazine medication, electroconvulsive therapy and leucotomy.’ J. nerv. ment. Dis., 143, 73–9.Google Scholar
Evans, J. H. (1965). ‘Persistent oral dyskinesia in treatment with phenothiazine derivatives.’ Lancet, i, 458–60.Google Scholar
Faurbye, A., Rasch, P. J., Peterson, P. B., Brandborg, G., and Pakkenberg, H. (1964). ‘Neurological symptoms in pharmacotherapy of psychoses.’ Acta psychiat. Scand., 40, 10–27.Google Scholar
Faurbye, A., Rasch, P. J., Peterson, P. B., Brandborg, G., and Pakkenberg, H. (1970). ‘The structural and biochemical basis of movement disorders in treatment with neuroleptic drugs and in extra-pyramidal diseases.’ Compr. Psychiat., 11, 205–25.CrossRefGoogle Scholar
Gottschalk, L. A., Gleser, G. C, Cleghorn, J. M., Stone, W. N., and Winget, C. N. (1970). ‘Prediction of changes in severity of the schizophrenic symptoms with discontinuation and administration of phenothiazines in chronic schizophrenic patients: language as a predictor and measure of change in schizophrenia.’ Compr. Psychiat., 11, 123–40.Google Scholar
Hamilton, M. (1965). ‘Ten years of chlorpromazine.’ Compr. Psychiat., 6, 291–7.Google Scholar
Hamilton, M., McGuire, R. J., and Goodman, M. J. (1965). ‘The PLUS system of programs: an integrated system of computer programs for biological data.’ Brit. J. math. stat. Psychol., 18, 265–6.Google Scholar
Hughes, J. S., and Little, J. C. (1967). ‘An appraisal of the continuing practice of prescribing tranquillizing drugs for long-stay psychiatric patients.’ Brit. J. Psychiat., 113, 867–73.CrossRefGoogle ScholarPubMed
Hunter, R., Earl, C. J., and Thornicroft, S. (1964). ‘An apparently irreversible syndrome of abnormal movements following phenothiazine medication.’ Proc. Roy. Soc. Med., 57, 24–8.Google Scholar
Judah, L. N., Josephs, Z. M., and Murphree, O. D. (1961). ‘Results of simultaneous abrupt withdrawal of ataraxics in 500 chronic psychotic patients.’ Amer. J. Psychiat., 118, 156–8.Google Scholar
Kennedy, P. F. (1969). ‘Chorea and phenothiazines.’ Brit. J. Psychiat., 115, 103–4.Google Scholar
Kennedy, P. F. Hershon, H. I., and McGuire, R. J. (1971). ‘Extra-pyramidal disorders after prolonged phenothiazine therapy, including a factor analytic study of clinical features.’ Brit. J. Psychiat., 118, 509–18.Google Scholar
McGeer, P. L., Boulding, J. E., Gibson, W. C., and Foulkes, R. G. (1961). ‘Drug-induced extrapyramidal reactions.’ J.A.M.A., 177, 665–70.Google Scholar
Morton, M. R. (1968). ‘A study of the withdrawal of chlorpromazine or trifluoperazine in chronic schizophrenics.’ Amer. J. Psychiat., 124, 1585–88.CrossRefGoogle ScholarPubMed
Prien, R. F., Cole, J. O., and Belkins, N. F. (1968). ‘Relapse in chronic schizophrenics following abrupt withdrawal of tranquillizing medication.’ Brit. J. Psychiat., 115, 679–86.Google Scholar
Pritchard, M. (1967). ‘Prognosis of schizophrenia before and after pharmacotherapy: three-year follow-up’. Brit. J. Psychiat., 113, 1353–59.Google Scholar
Pryce, I. G., and Edwards, H. (1966). ‘Persistent oral dyskinesia in female mental hospital patients.’ Brit. J. Psychiat., 112, 983–7.Google Scholar
Rothstein, C, Zeltzerman, I., and White, H. R. (1962). ‘Discontinuation of maintenance dosages of ataractic drugs on a psychiatric continued treatment ward.’ J. nerv. ment. Dis., 134, 555–60.Google Scholar
Sheppard, C., and Merlis, S. (1967). ‘Drug-induced extra-pyramidal symptoms: their incidence and treatment.’ Amer. J. Psychiat., 123, 886–9.Google Scholar
Slater, E., and Roth, M. (1969). Mayer-Gross, Slater and Roth's Clinical Psychiatry, 3rd Ed. Baillière, Tindall and Cassell, London.Google Scholar
Uhrbrand, L., and Faurbye, A. (1960). ‘Reversible and irreversible dyskinesia after treatment with perphenazine, chlorpromazine, reserpine and ECT.’ Psychopharmacologia, 1, 408.Google Scholar
Whittacker, C. B., and Hoy, R. M. (1963). ‘Withdrawal of perphenazine in chronic schizophrenia.’ Brit. J. Psychiat., 109, 422–7.Google Scholar
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