Fluphenazine enanthate induced decompensations.

Adverse behavorial reactions to fluphenazine enanthate have been reported.:; "Severe depressive mood changes"6.7 and "the fulminating acute onset of schizophrenic symptomatology"ll have been attributed to fluphenazine enanthate. Allan and White9 reported a case of catatonic-like stupor and disturbed temperature regulation precipitated by a large dose (100 mg) of fluphenazine decanoate. Goldberg et al,lo on the basis of a controlled study, concluded that fluphenazine enanthate "appears to be significantly superior to oral phenothiazines in the drug reluctant patient." They noted, in their analysis of covariance of Brief Psychiatric Rating Scale data, that some patients became worse on fluphenazine enanthate. Specifically, in a subgroup of patients who did not hallucinate or were not uncooperative, 32% of patients started to hallucinate, and 44% of patients became uncooperative. Also, some developed increased blunting of affect, increased suspicion, increased tension, and increased depression. This paper focusses on nine schizophrenic patients who experienced dramatic exacerbations of their original psychosis on fluphenazine enanthate in conventional dosages. These exacerbations of psychosis appear to be extrapyramidally based, and can be reversed by intramuscular biperiden (Akineton)-an anticholinergic drug. Response to biperiden is so prompt that it can be used as a diagnostic test.