Fluphenazine vs placebo supplementation for prodromal signs of relapse in schizophrenia

Stephen R. Marder, William C. Wirshing, Theodore Van Putten, Jim Mintz, Joanne McKenzie, Kathleen Johnston-Cronk, Malca Lebell, Robert P. Liberman

Research output: Contribution to journalArticle

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Abstract

Background: We studied the effectiveness of treating patients with low doses of fluphenazine decanoate and supplementing them with oral fluphenazine when there was evidence of prodromal symptoms of psychotic exacerbations. Methods: Eighty schizophrenic patients who were receiving 5 to 10 mg of fluphenazine decanoate every 2 weeks were monitored for prodromal symptoms using an idiosyncratic prodromal rating scale. When patients met our criteria for a prodromal episode, they were randomly assigned to a double-blind comparison of oral fluphenazine hydrochloride (5 mg twice daily) or a placebo for the current and future prodromal episodes. We compared rates of psychotic exacerbations in the two treatment groups. Results: Thirty-six patients (45%) met the criteria for a prodrome at some point during the trial and were randomized to drug or placebo. Using survival analysis during the entire 2 years, we did not find a significant difference between fluphenazine and placebo in the likelihood that a prodrome would continue to an exacerbation. Survival analysis beginning at the start of the second year of treatment did indicate a significant reduction in exacerbation risk for patients receiving drug supplementation (P=.032). Similarly, there was no difference between the two groups in the proportion of time at risk spent in exacerbation during the first year, but patients receiving active drug supplementation spent less time in an exacerbated state in the second year (P=.05). Conclusions: Our treatment strategy appeared to be effective for some patients, particularly those who were able to remain in the study beyond the first year. Although the occurrence of a prodrome was a fairly good marker that a patient was at high risk of ultimate exacerbation with our low-dose maintenance protocol, prodromes were not highly sensitive indicators of imminent exacerbation.

Original languageEnglish (US)
Pages (from-to)280-287
Number of pages8
JournalArchives of General Psychiatry
Volume51
Issue number4
StatePublished - Apr 1994
Externally publishedYes

Fingerprint

Prodromal Symptoms
Fluphenazine
Schizophrenia
Placebos
Recurrence
Survival Analysis
Pharmaceutical Preparations
Therapeutics
Maintenance

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Marder, S. R., Wirshing, W. C., Van Putten, T., Mintz, J., McKenzie, J., Johnston-Cronk, K., ... Liberman, R. P. (1994). Fluphenazine vs placebo supplementation for prodromal signs of relapse in schizophrenia. Archives of General Psychiatry, 51(4), 280-287.

Fluphenazine vs placebo supplementation for prodromal signs of relapse in schizophrenia. / Marder, Stephen R.; Wirshing, William C.; Van Putten, Theodore; Mintz, Jim; McKenzie, Joanne; Johnston-Cronk, Kathleen; Lebell, Malca; Liberman, Robert P.

In: Archives of General Psychiatry, Vol. 51, No. 4, 04.1994, p. 280-287.

Research output: Contribution to journalArticle

Marder, SR, Wirshing, WC, Van Putten, T, Mintz, J, McKenzie, J, Johnston-Cronk, K, Lebell, M & Liberman, RP 1994, 'Fluphenazine vs placebo supplementation for prodromal signs of relapse in schizophrenia', Archives of General Psychiatry, vol. 51, no. 4, pp. 280-287.
Marder SR, Wirshing WC, Van Putten T, Mintz J, McKenzie J, Johnston-Cronk K et al. Fluphenazine vs placebo supplementation for prodromal signs of relapse in schizophrenia. Archives of General Psychiatry. 1994 Apr;51(4):280-287.
Marder, Stephen R. ; Wirshing, William C. ; Van Putten, Theodore ; Mintz, Jim ; McKenzie, Joanne ; Johnston-Cronk, Kathleen ; Lebell, Malca ; Liberman, Robert P. / Fluphenazine vs placebo supplementation for prodromal signs of relapse in schizophrenia. In: Archives of General Psychiatry. 1994 ; Vol. 51, No. 4. pp. 280-287.
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