H. Freeman, S. D. Soni
May 1, 1980
Citations
0
Influential Citations
5
Citations
Journal
British Journal of Psychiatry
Abstract
Department ofBiochemistry Oxypertine is thought to exert its therapeutic effects by depleting pre-synaptic neuronal stores of neurotransmitters. Compared with reserpine and tetrabenazine, it is a more potentent depleter of brain noradrenaline, but has less dopamine depleting activity. It has been shown to be effective as a neuroleptic in controlling the symptoms of schizo phrenia, has not been recorded as causing depression, and is thought to be of value in activating patients with marked negative symptoms. It does not show acetylcholine-like properties, nor does it stimulate GABA-systems, both of which may be concerned in the production of TD. Chien, Jung and Ross-Townsend (1978) carried out a double-blind study to compare the efficacy of oxypertine, sodium valproate and dimethylamino ethanol in the control of TD, using a group of 17 patients. Only oxypertine was found to be sig nificantly superior to placebo, though the number of patients was too small to allow any final conclusion other than that oxypertine shows promise as a therapeutic agent in TD. In a so far unpublished paper, Kazamatsuri reports an open study of oxypertine in ten chronic mental hospital patients, all showing clear evidence of TD; out of these, seven experienced complete disappearance of their involuntary movements whilst receiving oxypertine. Neuroleptic drugs that were being administered before the trial were continued and no worsening of psychopathology was observed during the trial, nor did new side-effects emerge. Out of a total of 40 patients in four other uncontrolled studies, 22 are said to have shown either disappearance of TD or a marked improvement. Our study has consisted of a double-blind com parison of oxypertine versus placebo in in-patients, aged between 18 and 70, using the AIMS score. Patients selected for the trial had a drug-free period of two weeks, followed by drug or placebo for a month, another wash-out period and then a month on the other medication. The requirements listed by Mackay and Sheppard for a therapeutic trial in TD were very largely fulfilled. Only preliminary results are available so far; however, in the first half of the trial, patients receiving oxypertine (N = 10) showed a mean value of 50 per cent improvement, whereas those on placebo (N = 9) showed a mean improvement of 30 per cent. There is thus a significant trend in favour of oxypertine, but