Flupenthixol in relapse prevention in schizophrenics with comorbid alcoholism: Results from an open clinical study

Substance use, especially alcoholism, has been recognized as a
significant problem in schizophrenic patients, though only a few
studies on the effects of pharmacotherapy in these patients have
been conducted so far. The thioxanthene neuroleptic flupenthixol,
which can be given intramuscularly (i.m.) for improving compliance,
has been studied as a possible anti-craving drug both in animal
models of alcoholism and some clinical studies. Pilot studies
suggest that comorbid schizophrenics with substance use may benefit
from treatment with flupenthixol. Efficacy of flupenthixol (10-60
mg i.m.) in reducing alcohol consumption of dual diagnosis patients
was studied in an open 6-month clinical trial in 27 schizophrenics
with comorbid alcoholism. Twenty-one patients entered the
intention-to-treat analysis. Fourteen subjects were completers, 13
dropped out. Six patients completely abstained from alcohol during
treatment. Alcohol consumption was significantly reduced compared
to baseline (4 weeks before treatment as measured by timeline
follow-back interview). In general, while patients showed a marked
improvement concerning alcohol consumption, only a slight
improvement in psychopathology was recorded. Overall tolerability
was good. These data indicate a probable beneficial effect of
flupenthixol in schizophrenic patients with comorbid alcoholism.
Although the efficacy of flupenthixol as an anti-craving drug in
dual diagnosis patients has to be explored in further studies, the
drug may be considered a promising medication for these patients.
Copyright (C) 2003 S. Karger AG, Basel.