Open clinical study of Clopixol-Acuphase (zuclopenthixol acetate) treatment followed by Clopixol Depot in acute psychoses with long-term course tendency.

The evolution of 28 patients displaying acute forms of psychoses (schizophrenia, mania, exacerbation of psychosis in chronic cases) was studied under the treatment with Acuphase Acetate continued with Clopixol Depot. In both therapies a tioxantenic neuroleptic is involved for the acute form of the illness (Acuphase) and for the maintenance treatment (Clopixol Depot). The assessment of the results was carried out on individual observation files using Global Rating Scale (G.R.S.), B.P.R.S. and paraclinical measurement to appreciate the biological tolerance. Favourable effects of treatment were evident in the first 4 days and in six cases even within the first 24 hours. The whole group of patients showed a significant decrease of morbidity evolving from a high severity to a medium and reduced one. The biological tolerance was very good, 6 to 12 months' care.

Endogenous depression and imipramine levels in the blood.

Approximate determinations of imipramine plus desmethylimipramine levels in the blood made by a method available in routine clinical chemistry laboratories, in 20 nondelusional endogenous depressives after 3 weeks of treatment (mean dose 130 mg/day, SEM 18.05 mg/day) have shown levels ranging from 10 ng/ml to 494 ng/ml. A positive significant correlation between blood levels and percentage change in scores on the Hamilton scale was found (Spearman's O = 0.49 P < 0.05). Patients with levels above 85 ng/ml had a significantly better therapeutic response than patients with levels below 85 ng/ml. Among the 11 nonresponders, 8 had low levels, 2 had intermediate levels, and 1 had the highest level of the study. In a given nonresponder, approximate determination of imipramine plus desmethylimipramine in the blood may be useful.