The treatment of psychotic issues such as schizophrenia typically involves the use of antipsychotic medications and behavioral therapy. Most antipsychotic medications fall into two broad categories: typical and atypical. The typical antipsychotics were developed in the 1950s and 60s and were considered very effective. Haldol (haloperidol) and Prolixin (fluphenazine) are the primary typical antipsychotics still in use, mainly because of their potency and fast action.
Most of the typical antipsychotics have recently fallen out of favor because of their potential for severe side effects. Movement problems, including muscle spasm and facial tics, are common side effects from the atypical antipsychotic medications. Patented in the last twenty years, the typical antipsychotics have generally taken the place of the older antipsychotic medications. The introduction of these second generation antipsychotics, such as Abilify (aripiprazole), promised effective treatment of schizophrenia with fewer adverse effects. Recent studies, however, have called this conventional wisdom into question.
At the Yale New Haven Psychiatric Hospital, clinical researchers were looking for an alternative to Haldol and Prolixin in the treatment of psychotic mental health problems. The doctors and staff felt limited by having only two typical antipsychotic medications in their treatment arsenal. Trilafon (perphenazine), a less potent typical antipsychotic was selected as a candidate. The New Haven pharmacy formulated a liquid version of the medication, making dosage easier for agitated individuals.
Many people don’t respond to the newer antipsychotics. At the same time, Haldol and Prolixin are often not well tolerated because of their potency. Rather than a complete clinical trial, researchers opted to merely observe and gather data on the effectiveness and safety of Trilafon in the hospital population. Chart reviews provided the necessary information regarding medications, adverse effects, and results of treatment.
To the surprise of some in the research team, Trilafon proved just as safe and effective in the treatment of schizophrenia as the newer, typical antipsychotic medications. Granted, all of the subjects were people in the psychiatric hospital, and therefore they experienced constant monitoring and a carefully controlled environment. The researchers argue from these results that a wider selection of both typical and atypical antipsychotic medications should be available to hospital pharmacies. Drug tolerance and effectiveness varies from one individual to the next, and having a wider selection of treatment drugs is always a step in the right direction.
References:
- Chrisphonte, P., Ostroff, R., & Rosenheck, R. (2012). Perphenazine suspension: a new, old treatment, side effects and continuous use. The Psychiatry Quarterly, Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22271354
- Perphenazine – PubMed Health. (n.d.). National Center for Biotechnology Information. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000601/
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