Search

Fifty chronic schizophrenic patients were included in a double-blind, crossover clinical and metabolite comparison of generic and Thorazine brand forms of chlorpromazine. Improvement was similar in quality and degree with the two compounds; there was no difference in frequency or severity of side effects or in incidence of laboratory abnormalities. Side effects consisted mainly of extrapyramidal reactions, drowsiness, and hypotension; the most serious were grand mal seizures that occurred in 2 patients, one on each compound. Weight changes and neuroleptic threshold were similar. Kinetic studies were carried out during the drug-free intervals. Chlorpromazine, chlorpromazine nor1 + 2, and chlorpromazine sulfoxide nor1 + 2 were measured over a 24 hour period. The characteristics of the mean curves were similar, although there were marked interindividual differences. The urinary recovery over the same period also demonstrated wide individual variability although the results from the same patients were similar. Because of the consistent similarites between generic and brand-named chlorpromazine on the wide range of dimensions evaluated, we concluded that the two compounds were bioequivalent. The results suggest that the methodology used by us for examining bioequivalency is practicable and adequate.

Reports have been accumulating in the literature attesting to the failure of patients, particularly out-patients, to take medication as prescribed (Stewart and Cluff, 1972; Moulding et al., 1970). The incidence of these failures, which may include anything from missing occasional doses to taking no medication at all, has been reported to range from 25–59 Per cent. In addition, it has not been possible to identify those patients who will have the highest failure rates (Blackwell, 1972). While most of the studies have involved medical patients, it is probably legitimate to assume that schizophrenic patients are at least as unreliable in taking medication as the medical patients. Thus, in one study of 125 psychiatric patients, Willcox et al. (1965) found that 48 per cent took no medication at all.

A correlation was found between clinical depression and the presence of either osteoporosis or osteoarthritis. Sex, age and race influenced which disease pattern was expressed. Other research has indicated a relationship between parathyroid disease and depression. The effectiveness of lithium therapy in affective disorders is also of possible relevance. The nature of the relationship between mineral metabolism and affective disease may well lead to an explanation of the pathogenesis of affective disorders.