==================================BSR22================================== 22. Any articles relating Phenothiazine or butyrophenone plasma concentrations to adverse effects or toxicity. Any articles measuring pemoline plasma (serum) concentrations. 1 UI - 87050356 AU - De Cuyper H ; Bollen J ; van Praag HM ; Verstraeten D TI - Pharmacokinetics and therapeutic efficacy of haloperidol decanoate after loading dose administration. AB - For this open study, we selected 21 chronic psychotic female in-patients (16 of them schizophrenics) who were being maintained on oral neuroleptics. After a wash-out period, they were treated by intramuscular depot injections of haloperidol decanoate, once a month for four months. The dose was calculated from the previous oral dosage, and the amount of the first injection was double that of the three following injections. Relatively stable plasma levels of haloperidol were achieved with the first injection, and corresponded to those observed with oral medication. A very significant correlation was found between plasma level and the dose administered, but not between plasma level and therapeutic effect. The clinical condition of about two-thirds of the patients remained unchanged or improved, compared with the period of oral treatment. During the first two months of treatment, there was more rigidity and tremor, but from the third month, the extrapyramidal symptoms were less pronounced than during the period of oral neuroleptics. MH - Adult ; Aged ; Butyrophenone Tranquilizers/ADVERSE EFFECTS/BLOOD/ *THERAPEUTIC USE ; Dyskinesia, Drug-Induced/ETIOLOGY ; Female ; Haloperidol/*ANALOGS & DERIVATIVES/ADVERSE EFFECTS/METABOLISM/THERAPEUTIC USE ; Human ; Kinetics ; Middle Age ; Psychiatric Status Rating Scales ; Psychotic Disorders/BLOOD/*DRUG THERAPY SO - Br J Psychiatry 1986 May;148:560-6 2 UI - 86292808 AU - Ryder KW ; Glick MR TI - The effect of thioridazine on the Automatic Clinical Analyzer serum tricyclic anti-depressant screen. AB - A patient who had ingested thioridazine and flurazepam was brought to the authors' emergency department. Initial laboratory evaluation included a positive result for a serum screening test for tricyclic anti-depressants performed with the DuPont Automatic Clinical Analyzer. This false positive test result caused considerable unnecessary treatment and expense for the patient. The authors have found that a serum thioridazine concentration of 125 ng/mL (within the usual therapeutic range for this drug) will produce a false positive automatic clinical analyzer serum tricyclic anti-depressant screen result. Because thioridazine is the most widely used phenothiazine and is prescribed more frequently than the most widely used tricyclic anti-depressant, it is important to recognize this cause of a false positive result. MH - Antidepressive Agents, Tricyclic/*BLOOD/POISONING ; Autoanalysis/ *INSTRUMENTATION ; Blood Chemical Analysis/*INSTRUMENTATION ; Case Report ; False Positive Reactions ; Female ; Human ; Middle Age ; Thioridazine/ *BLOOD/POISONING SO - Am J Clin Pathol 1986 Aug;86(2):248-9 3 UI - 86224710 AU - McEvoy JP ; Stiller RL ; Farr R TI - Plasma haloperidol levels drawn at neuroleptic threshold doses: a pilot study. AB - The daily haloperidol doses of 33 newly admitted, acutely psychotic schizophrenic patients were rapidly adjusted to a point at which slight hypokinesia-rigidity first appeared on clinical examination (the neuroleptic threshold). The mean daily haloperidol dose at which the neuroleptic threshold was crossed was 4.2 +/- 2.4 mg/day. The plasma haloperidol levels obtained at these neuroleptic threshold doses clustered around a mean of 4.9 +/- 2.9 ng/ml. This plasma haloperidol level distribution extensively overlaps the proposed lower boundaries for the therapeutically effective range of plasma haloperidol levels, but it is below the range in which coarse extrapyramidal side effects appear in high frequency (greater than 10 ng/ml). Sixty-seven percent of our patients demonstrated moderate or greater therapeutic improvement within 3 weeks of treatment at neuroleptic threshold doses, a therapeutic efficacy rate identical to that expected with standard neuroleptic doses. The authors propose that the neuroleptic threshold is a readily available clinical marker which identifies a range of plasma haloperidol levels capable of producing therapeutic response with minimal associated coarse extrapyramidal side effects. MH - Adolescence ; Adult ; Basal Ganglia Diseases/CHEMICALLY INDUCED ; Dose-Response Relationship, Drug ; Female ; Haloperidol/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS/*BLOOD ; Human ; Male ; Middle Age ; Motor Activity/DRUG EFFECTS ; Muscle Rigidity/CHEMICALLY INDUCED ; Radioimmunoassay ; Schizophrenia/DRUG THERAPY SO - J Clin Psychopharmacol 1986 Jun;6(3):133-8 4 UI - 86206596 AU - Marder SR ; Hawes EM ; Van Putten T ; Hubbard JW ; McKay G ; Mintz J ; May PR ; Midha KK TI - Fluphenazine plasma levels in patients receiving low and conventional doses of fluphenazine decanoate. AB - Plasma fluphenazine concentrations (FLU) were measured in 45 patients with schizophrenic disorders who participated in a double-blind comparison of 5 and 25 mg fluphenazine decanoate (FD). The rise in plasma level of FLU 24 h after a "test dose: was significantly correlated with steady state FLU concentration at 12 weeks (for 5 mg patients, r = 0.45, P = 0.04; for 25 mg, r = 0.78, P = 0.005). Patients who had low FLU at baseline required nearly 6 months to reach a steady state when they received 25 mg. Patients who received 5 mg and had low FLU at baseline continued to demonstrate relatively low plasma levels for the entire 1st year. Although the mean FLU at 6 months was lower for patients who relapsed during the subsequent 18 months (0.57 ng/ml for relapsers vs 1.01 ng/ml for nonrelapsers), this difference was not statistically significant. When plasma levels from both dosage groups were combined, FLU at 12 weeks correlated significantly with factor scores for akinesia (r = 0.52, P = 0.002) and BPRS cluster scores for retardation (r = 0.52, P = 0.002). These results indicate that the measurement of fluphenazine plasma levels may be useful in determining when patients treated with FD are receiving drug doses which are likely to cause discomforting side effects. MH - Adult ; Clinical Trials ; Comparative Study ; Double-Blind Method ; Fluphenazine/*ANALOGS & DERIVATIVES/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS/BLOOD ; Human ; Kinetics ; Male ; Middle Age ; Schizophrenia/ *DRUG THERAPY ; Support, U.S. Gov't, Non-P.H.S. ; Support, U.S. Gov't, P.H.S. SO - Psychopharmacology (Berlin) 1986;88(4):480-3