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Theodore Van Putten, MD; Louis R. Mutalipassi, PhD; Michael D. Malkin, MD

Arch Gen Psychiatry. 1974;30(1):102-105.

Abstract
Adverse mental reactions to phenothiazines have been anecdotally reported. In a systematic study 80 patients with the diagnosis of schizophrenia received phenothiazines in conventional dosages. Nine patients experienced dramatic exacerbations of psychosis on phenothiazines with a piperazine side group—particularly fluphenazine enanthate.

These exacerbations of psychosis are associated with a subtle akathisia. Exacerbations of psychosis were promptly reversed by biperiden (Akineton)—an anticholinergic drug, given intramuscularly.

It is proposed that extrapyramidal involvement can have a prominent mental component which resembles an exacerbation of schizophrenia.

Author Affiliations
Los Angeles

From the Brentwood Veterans Administration Hospital and the UCLA School of Medicine, Los Angeles.

Footnotes
Accepted for publication June 19, 1973.

Reprint requests to Brentwood VA Hospital, Wilshire & Sawtelle Blvd, Ward 210-C, Los Angeles, CA 90072 (Dr. Van Putten).

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