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European Archives of Psychiatry and Clinical Neuroscience
Published in: European Archives of Psychiatry and Clinical Neuroscience 2/2014

01-03-2014 | Original Paper

Flupentixol use and adverse reactions in comparison with other common first- and second-generation antipsychotics: data from the AMSP study

Authors: R. Grohmann, R. R. Engel, H.-J. Möller, E. Rüther, J. W. van der Velden, S. Stübner

Published in: European Archives of Psychiatry and Clinical Neuroscience | Issue 2/2014

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Abstract

This study compares the first-generation antipsychotic (FGA) flupentixol to haloperidol and common second-generation antipsychotics (SGAs) as to drug utilization and severe adverse drug reactions (ADRs) in clinical treatment of schizophrenia inpatients using data from the drug safety program Arzneimittelsicherheit in der Psychiatrie (AMSP). AMSP drug utilization and reported ADR data were analyzed. Type and frequency of severe ADRs attributed to flupentixol were compared with haloperidol, clozapine, olanzapine, quetiapine, risperidone and amisulpride in a total of 56,861 schizophrenia inpatients exposed to these drugs. In spite of increasing prescription of SGAs, flupentixol was consistently used in schizophrenic inpatients (about 5 %) over time. Reporting rates of severe ADR ranged from 0.38 to 1.20 % for the individual antipsychotics (drugs imputed alone); flupentixol ranked lowest. The type of ADR differed considerably; as to severe EPMS, flupentixol (0.27 %), such as risperidone (0.28 %), held an intermediate position between haloperidol/amisulpride (0.55/0.52 %) and olanzapine/quetiapine (<0.1 %). The study is a heuristic approach, not a confirmatory test. Flupentixol has a stable place in the treatment of schizophrenia in spite of the introduction of different SGAs. Comparative ADR profiles suggest an intermediate position between FGAs and SGAs for flupentixol in clinical practice.
Literature
1.
Allison D, Mentore J, Heo M, Chandler L, Cappelleri J, Infante M, Weiden P (1999) Antipsychotic-induced weight gain: a comprehensive research synthesis. Am J Psychiatry 156:1686–1696PubMed
2.
Beamont P, Gleder M, Friesen H, Harris G, MacKinnon B, Mandelbrote B (1974) The effects of phenothiazines on endocrine function. Patients with inadequate lactation and amenorrhea. Br J Psychiatry 124:413–419CrossRef
3.
Canales PL, Olsen J, Miller AL et al (1999) Role of antipsychotic polypharmacotherapy in the treatment of schizophrenia. CNS Drugs 12:179–188CrossRef
4.
Caroff SN, Mann SC, Campbell EC, Sullivan KA (2002) Movement disorders associated with atypical antipsychotic drugs. J Clin Psychiatry 63:12–19PubMed
5.
Caroff SN (1980) The neuroleptic malignant syndrome. J Clin Psychiatry 41:79–83PubMed
6.
Cicarelli E, Razzore P, Gaia D (2001) Hyperprolactinämia and provatine in benign intracranial tumors. J Neurosurg Sci 45:70
7.
Dolder CR, Lacro JP, Dunn LB, Jeste DV (2002) Antipsychotic medication adherence: is there a difference between typical and atypical agents? Am J Psychiatry 159:103–108PubMedCrossRef
8.
Engel RR, Grohmann R, Rüther E, Hippius H (2004) Research methods in drug surveillance. Pharmacopsychiatry 37(Suppl 1):12–15
9.
Ganguly R, Kotzan JA, Miller LS, Kennedy K, Martin BC (2004) Prevalence, trends, and factors associated with antipsychotic polypharmacy among medicaid-eligible schizophrenia patients, 1998–2000. J Clin Psychiatry 65:1377–1388PubMedCrossRef
10.
Gardner DM, Murphy AL, O’Donnell H, Centorrino F, Baldessarini RJ (2010) International consensus study of antipsychotic dosing. Am J Psychiatry 167:686–693PubMedCrossRef
11.
Gattaz WF, Diehl A, Geuppert MS et al (2004) Olanzapine versus flupentixol in the treatment of inpatients with schizophrenia: a randomized double-blind trial. Pharmacopsychiatry 37(Suppl 1):279–285PubMedCrossRef
12.
Glaser T, Sommermeyer H, Faßbender M, Mauler F (1998) Das Rezeptorbindungsprofil von cis-Flupentixol. In: Glaser T, Soyka M (eds) Flupentixol. Steinkopff Verlag, Darmstadt, pp 9–20
13.
Grohmann R, Engel RR, Geissler KH, Rüther E (2004) Psychotropic drug use in psychiatric inpatients: recent trends and changes over time—data from the AMSP study. Pharmacopsychiatry 37(Suppl 1):27–38
14.
Grohmann R, Engel RR, Rüther E, Hippius H (2004) The AMSP drug safety program: methods and global results. Pharmacopsychiatry 37(Suppl 1):4–11
15.
Grohmann R, Hippius H, Helmchen H, Rüther E, Schmidt LG (2004) The AMÜP study for drug surveillance in psychiatry—a summary of inpatient data. Pharmacopsychiatry 37(Suppl 1):16–26
16.
Grohmann R, Rüther E (1994) Neuroleptika. In: Grohmann R, Rüther E, Schmidt LG (eds) Unerwünschte Wirkungen von Psychopharmaka. Springer, Berlin, pp 43–133CrossRef
17.
Gruber AJ, Cole JO (1991) Antidepressant effects of flupentixol. Pharmacotherapy 11:450–459PubMed
18.
Gründer G, Hiemke C, Paulzen M, Veselinovic T, Vernaleken I (2011) Therapeutic plasma concentrations of antidepressants and antipsychotics: lessons from PET imaging. Pharmacopsychiatry 44:236–248PubMedCrossRef
19.
Hamner M, Arana G (1998) Hyperprolactinaemia in antipsychotic-treated patients: guidelines for avoidance and management. CNS Drugs 10:209–222CrossRef
20.
Hertling I, Philipp M, Dvorak A et al (2003) Flupentixol versus risperidone: subjective quality of life as an important factor for compliance in chronic schizophrenic patients. Neuropsychobiology 47:37–46PubMedCrossRef
21.
Hippius H, Kanig K (1958) Die Agranulocytose unter neuro-psychiatrischer Phenothiazin-Therapie. Ärztl Wochenschrift 13:501–507
22.
Idänpään-Heikkilä J, Alhava E, Olkinuora M, Palva I (1977) Agranulocytosis during treatment with clozapine. Eur J Clin Pharmacol 11:193–198PubMedCrossRef
23.
Leucht S, Corves C, Engel RR, Davies JM (2009) Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis. Lancet 373:31–41PubMedCrossRef
24.
Marder SR, McQuade RD, Stock E, Kaplita S, Marcus R, Safferman AZ, Saha A, Ali M, Iwamoto T (2003) Aripiprazole in the treatment of schizophrenia: safety and tolerability in short-term, placebo-controlled trials. Schizophr Res 61:123–136PubMedCrossRef
25.
Meisenzahl EM, Schmitt G, Gründer G, Dresel S, Frodl T, la Fougère C, Scheuerecker J, Schwarz M, Boerner R, Strauss J, Hahn K, Möller HJ (2008) Striatal D2/D3 receptor occupancy, clinical response and side effects with amisulpride: an iodine-123-iodobenzamide SPET study. Pharmacopsychiatry 41:169–175PubMedCrossRef
26.
Nasrallah H, Tandon R (2002) Efficacy, safety and tolerability of quetiapine in patients with schizophrenia. J Clin Psychiatry 63:12–20PubMedCrossRef
27.
Paton C, Lelliott P, Harrington M, Okocha C, Sensky T, Duffett R (2003) Patterns of antipsychotic and anticholinergic prescribing for hospital inpatients. J Psychopharmacol 17(2):223–229PubMedCrossRef
28.
Ruhrmann S, Kissling W, Lesch OW et al (2007) Efficacy of flupentixol and risperidone in chronic schizophrenia with predominantly negative symptoms. Prog Neuropsychopharmacol Biol Psychiatry 31:1012–1022PubMedCrossRef
29.
Schotte A, Janssen PFM, Gommeren W, Luyten WHML, Van Gompel P, Lesage AS, De Loore K, Leysen JE (1996) Risperidone compared with new and reference antipsychotic drugs: in vitro and in vivo receptor bindings. Psychopharmacology 124:57–73PubMedCrossRef
30.
Stübner S, Rustenbeck E, Grohmann R, Wagner G, Engel R, Neundörfer G, Möller HJ, Hippius H, Rüther E (2004) Severe and uncommon involuntary movement disorders due to psychotropic drugs. Pharmacopsychiatry 37(Suppl 1):54–64
31.
Touraine P, Martini J, Zafrani B (1998) Increased expression of prolactin receptor gene assessed by quantitative polymerase chain reaction in human breast tumors versus normal breast tissues. J Clin Endocrinol Metab 83:667PubMedCrossRef
32.
Volavka J, Czobor P, Cooper T, Sheitman B, Lindenmayer P, Citrome L, McEvoy J, Lieberman J (2004) Prolactin levels in schizophrenia and schizoaffective disorder patients treated with clozapine, olanzapine, risperidon or haloperidol. J Clin Psychiatry 65:57–61PubMedCrossRef
33.
34.
35.
36.
Yood MU, DeLorenze G, Quesenberry CP Jr, Oliveria SA, Tsai AL, Willey VJ, McQuade R, Newcomer J, L’Italien G (2009) The incidence of diabetes in atypical antipsychotic users differs according to agent—results from a multisite epidemiologic study. Pharmacoepidemiol Drug Saf 18(9):791–799PubMedCrossRef
Metadata
Title
Flupentixol use and adverse reactions in comparison with other common first- and second-generation antipsychotics: data from the AMSP study
Authors
R. Grohmann
R. R. Engel
H.-J. Möller
E. Rüther
J. W. van der Velden
S. Stübner
Publication date
01-03-2014
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Psychiatry and Clinical Neuroscience / Issue 2/2014
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI
https://doi.org/10.1007/s00406-013-0419-y

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