Abstract
Fifteen psychotic patients in whom severe autism, abulia and negativism were apparent and it was difficult to initiate lifeguidance or occupational therapy were given Triperidol (a butyrophenone derivative) in the form of drops.
1) The subject consisted of 10 patients with chronic schizophrenia, 1 with fresh schizo- phrenia, 2 with progressive paralysis and 2 with epilepsy.
A long morbid period was the common feature in all patients and every available method of special psychiatric therapy and pharmacotherapy had been attempted without satisfactory results.
2) The main psychotic symptoms were autism, abulia, indifference, negativism, lack of rapport, loss of spontaneity etc, in 10 chronic schizophrenic patients and irritability, moodiness, unrest, negativism or psychomotor excitement in 5 patients with fresh schizophreniz, progressive paralysis or epilepsy.
3) Administration and dosage: The preparation was administered orally starting with a dose of 9 drops (0.45mg) which was gradually increased up to 90 drops (4.5mg) at maximum then to be reduced gradually. The total amount of the drug given ranged from 9.45mg to 411.3mg and the period of medication from 14 to 183 consecutive days. For 10 patients who refused ingestion of drugs the intended dose of Triperidol was mixed in the food and was given without difficulty. The rest of the patients received the drug in the form of drops.
4) Result: three patients showed a remarkable response (20.0%), 5 more or less positive response (33.3%), 4 only temporary improvement (26.7%) and 3 no effect (20.0%). The effective ratio was 80%. The drug was effective by 100% against the defect-symptoms of chronic schizophrenia such as autism, abulia, indifference, negativism, lack of rapport, loss of spontaneity, by 60% against abnormal experience such as hallucination or delusion, and by 33% against agitated state such as irritability or psychomotor excitement.
5) Side-effects: sleep disturbance was observed in 73% of the treated patients, parkinson's syndrome in 73% and so-called restless akathisia of Divry in 53%. All these sideeffects were overcome by symptomatic treatment without discontinuing the therapy.
Moreover, in 4 cases improvement of autism paralleled with so-called akathisia of Divry, and in 5 cases an increase of body-weight occurred apparently as a result of the improvement of anorexia.
6) The preparation has no disagreeable taste and easily be administered in drug-refusing patients. And its therapeutic effect has led to a successful introduction of life-guidance and occupational therapy in the treatment of difficult psychotic patients.
