Erfassung neuroleptisch bedingter extrapyramidaler Syndrome in einem psychopharmakologischen Forschungsprojekt

Methodological questions of clinical observation and classification of drug-induced extrapyramidal symptomatology are discussed. In our experimental approach we examined two groups of 20 acute schizophrenic patients each. The patients were treated for 4 weeks under double-blind conditions with the butyrophenone derivative Haloperidol and with the benzoxazepine derivative Loxapin respectively. The extrapyramidal disturbances appearing under these medications were studied. The patients were examined by means of the EPS-scale by Simpson and Angus weekly, before, during and after this treatment as well as under a subsequent therapy with a longacting neuroleptic. Extrapyramidal disturbances appearing between these fixed rating times were noted in a check list. According to a classification propased by Chien and Di-Mascio the symptomatology of extrapyramidal disturbances under neuroleptic therapy can be divided into "permanent neuroleptic manifestations" on the one hand and "paroxysmal neurodysleptic manifestations" on the other. While Haloperidol caused more distinct symptoms of permanent neuroleptic manifestations, acute neurodysleptic reactions appeared more frequently under Loxapin therapy.