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The prolactin response to nemonapride, a new antipsychotic drug, was studied in 27 schizophrenic inpatients (12 males, 15 females). The daily dose of nemonapride was 18 mg/day, and the duration of treatment was 3 weeks. Plasma prolactin concentrations were measured by enzyme immunoassay. Nemonapride treatment significantly (p <0·01) increased prolactin concentrations at each week in both genders. The Δprolactin (the mean concentration during 3 weeks minus the pretreatment concentration) was significantly (p <0·01) greater in females (mean± SD, 81·6±57·8 ng/ml) than males (34·9±19·8 ng/ml). The present study thus shows that nemonapride treatment markedly increases prolactin concentrations in schizophrenic patients, with greater responses in females than males, suggesting a strong D2 receptor blockade property of the drug. © 1997 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The steady-state serum kinetics of zotepine, an antipsychotic drug, were studied in 59 psychiatric in-patients receiving 50-500 mg/day (mean 215 mg/day) of the drug. There was a 26-fold inter-individual variation in the concentration/dose ratios (C/D ratios: ng/ml/mg/kg), which ranged from 2.4 to 62.2 (mean 13.2). The smokers (n = 37) had significantly lower C/D ratios (mean ±SD: 9.7 ± 7.0 vs 19.0 ± 15.5,p <0.01), while the patients co-administered benzodiazepines (n = 14) had significantly higher C/D ratios (19.6 ± 12.5 vs 11.2 ± 10.9, p< 0.01) than the others. There was no significant relationship between the C/D ratios and age or gender. In the 24 cases where the dose was fixed at 100 mg/day in the first week and at 200 mg/day for the next 3 weeks, no significant difference was found in the mean C/D ratios during the 4 weeks. The present study thus suggests a large inter-individual variation in the metabolism of zotepine, and that smoking enhances, and co-administration of benzodiazepines inhibits, the metabolism. Age and gender do not affect the kinetics of the drug. The results also suggest no dose-dependent kinetics and no enzyme-inducing effect of the drug. [ABSTRACT FROM AUTHOR]

A 67-year-old schizophrenic woman developed neuroleptic malignant syndrome (NMS). She had mild diabetes mellitus, which had been controlled with diet therapy only. Upon the onset of NMS, hyperglycemia of up to 490 mg/dl developed. The hyperglycemia persisted during the NMS episode despite insulin treatment, and subsided only after the symptoms of NMS disappeared. The present report suggests that hyperglycemia may develop as a symptom of NMS, especially in patients with pre-existing impaired glucose tolerance, and that blood glucose should be monitored during NMS episodes. [ABSTRACT FROM AUTHOR]