Sulpiride and haloperidol in schizophrenia: a double-blind cross-over study of therapeutic effect, side effects and plasma concentrations.

In a double-blind cross-over trial, 20 chronic schizophrenic patients were treated with sulpiride and haloperidol in two 12-week periods. The final median dose of sulpiride was 2000 mg/day (range 800-3200) and of haloperidol 12 mg/day (range 6-24). Sulpiride had an antipsychotic effect and therapeutic profile not significantly different from that of haloperidol. In spite of the high doses of sulpiride, extrapyramidal side-effects were seen less frequently during the first four weeks of the sulpiride period than during the corresponding haloperidol period (P less than 0.05), whereas autonomic side-effects were equally rare for both drugs. A positive correlation was found between daily dose and plasma concentration of both sulpiride (P less than 0.001) and haloperidol (P less than 0.05), but no correlation could be established between clinical effects and plasma levels of either neuroleptic.

Sulpiride versus haloperidol, a clinical trial in schizophrenia. A preliminary report.

Sixteen out of 25 hebephrenic and paranoid schizophrenic patients completed a double-blind cross-over study with sulpiride and haloperidol. The patient sample was relatively chronic: Median age was 35 years (range 26-53 years), median duration of illness 10 years (4-35 years), and median duration of neuroleptic treatment 5 years (1-28 years). Each patient was treated with sulpiride/haloperidol in random order for 12 weeks with a drug-free period before each treatment phase. Mean total BPRS (Brief Psychiatric Rating Scale) score was reduced from 25 to 15 (P less than 0.05) during sulpiride (800-2800 mg/day, median 1600 mg/day), and from 28 to 15 (P less than 0.01) during haloperidol (6-18 mg/day, median 12). There were no significant differences between the groups with respect to total BPRS score, single items or symptom clusters. However, in a few, very "chronic", disturbed, and long-term treated patients, haloperidol appeared more beneficial than sulpiride. Autonomic side effects and parkinsonism tended to occur more frequently during haloperidol than during sulpiride, but no significant differences were found. It is concluded that sulpiride, a specific dopamine-2 receptor blocker, has antipsychotic effect, not significantly different from haloperidol, but may produce slightly less side effects.

Antithymic immune factor in schizophrenia. A World Health Organization study.

Six WHO Collaborating Centre took part in the study of the antithymic activity of blood sera of patients suffering from schizophrenia. Blood serum specimens from 118 schizophrenic patients and 62 mentally healthy donors were investigated. Statistically significant differences between schizophrenic patients and the controls were found (p < 0.05). It is probable that as with other biological phenomena described in schizophrenia, antithymic activity is one of the biological factors, in combination with other factors, predisposing towards the development of the schizophrenic process.

d-Propoxyphene kinetics after single oral and intravenous doses in man.

d-Propoxyphene kinetics was studied in 8 healthy male subjects after single oral doses of d-propoxyphene at 65, 130, and 190 mg and after slow intravenous infusion of 65 mg. Total urinary excretion (7 days) indicated complete oral absorption but systemic availability was reduced corresponding to fist-pass elimination of 30% to 70%. There was linearity between oral dose and the corresponding area under the plasma concentration/time curve of d-propoxyphene and the metabolite norpropoxyphene. The kinetic measurements showed 2- to 3-fold interindividual variations: oral clearance, 1.3 to 3.6 1/min; systemic clearance, 0.6 to 1.2 1/min; apparent volume of distribution, 700 to 1,800 1; d-propoxyphene half-life (t1/2), 8 to 24 hr; and norpropoxyphene t1/2, 18 to 29 hr. There were pronounced intraindividual dose-dependent variations in oral clearance in some subjects. The intravenous concentration curves indicated a 3-compartment distribution model.

Lithium inhibits basal and food-stimulated gastrin secretion.

Ten psychiatric patients were given a protein-rich meal in periods on and off lithium administration. The concentrations of gastrin in serum were measured radioimmunochemically before and during the meal. The results show that lithium suppresses basal as well as food-stimulated gastrin secretion.