Neuroleptic-induced seizures. An in vitro technique for assessing relative risk.

To estimate the relative risk of various neuroleptic medications for patients with epilepsy or likely to have neuroleptic-induced seizures, their action on spike activity in perfused guinea pig hippocampal slices was studied. Within the range of concentrations studied, molindone hydrochloride, butaclamol hydrochloride, pimozide, and fluphenazine dihydrochloride produced the least increase in excitability. There were also differences in the dose-response curves. Chlorpromazine, thioridazine, and pimozide produced an inverted U-shaped curve. For haloperidol and fluphenazine, excitability tended to increase and them plateau. Molindone and butaclamol produced no increase in excitability. Combinations of neuroleptics had synergistic effects, while the anticonvulsant diazepam inhibited neuroleptic-induced excitability. This article discusses the clinical implications of these findings and their effect on theories of which neuroleptics might produce the fewest seizures.

Butaclamol in the treatment of schizophrenia. A standard-controlled clinical trial.

A 16-week, standard-controlled, double-blind study was conducted to compare the efficacy of butaclamol with that of fluphenazine in the treatment of 24 newly admitted schizophrenic patients. Statistically significant improvement occurred in the entire population in the total scores of the BPRS and PAS; in the activation, anergia, thought disturbance and hostile/suspiciousness factor scores of the BPRS; and in the scores of 9 of the 12 factors of the PAS. There were no statistically significant differences between the scores of the two treatment groups on the total or factor scores of either scale during the course of the clinical trial. The most frequently occurring adverse effects in the butaclamol group were rigidity, akathisia and excitement/agitation. The most frequently occurring adverse effects in the fluphenazine group were insomnia, decreased motor activity and tremor. It is concluded that butaclamol exerts potent neuroleptic effects on schizophrenic patients.

Butaclamol in newly admitted chronic schizophrenic patients: a modified fixed-dose dose-range design.

In a double-blind placebo controlled study of newly admitted chronic schizophrenics, an attempt was made to further evaluate the safety, acceptability, and effectiveness of BT in doses of 10, 20, and 40 mg. Significant dose related responses occurred on several behavioral variables by the first week of treatment. Maximum clinical response appeared to be at the 20-40 mg. dose level. Extrapyramidal signs occurred at all doses, but with greater severity at higher doses. Excessive daytime drowsiness occurred in all groups but with longer duration and greater intensity in the 20 mg. group. Rebound insomnia occurred after the abrupt withdrawal of BT at all dose levels suggesting the desirability of further study of its hypnotic properties.