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August 1990

Surreptitious Noncompliance With Oral Fluphenazine in a Voluntary Inpatient Population

Author Affiliations

Department of Psychiatry Veterans Administration Medical Center 11301 Wilshire Blvd Bldg 210C Los Angeles, CA 90073

Arch Gen Psychiatry. 1990;47(8):786-787. doi:10.1001/archpsyc.1990.01810200094015

To the Editor.—  It is well-known that schizophrenic inpatients do not always swallow their neuroleptic tablets. Default rates in schizophrenic inpatient populations have been reported to range from 5% to 37%, using the semiqualitative Forrest test for phenothiazine derivatives in urine.1 We report herein a surprisingly high rate of surreptitious noncompliance in a research sample using a sensitive fluphenazine radioimmunoassay.2

Subjects and Methods.—  Ninety-one newly readmitted drug-free (for at least 2 weeks, but usually several months), schizophrenic (by DSM-III) men were randomly assigned to receive fluphenazine in dosages of either 5, 10, or 20 mg daily for 4 weeks. After these 4 weeks, the dosage could be increased. Patients with a history of nonresponsiveness to neuroleptic drugs were excluded. All patients were voluntarily admitted and gave an informed consent at baseline.These patients were in their early 30s and had four previous hospitalizations. They had all

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