Penfluridol (Semap, Micefal, Longoperidol) is a highly potent, first generation
diphenylbutylpiperidineantipsychotic.[2] It was discovered at
Janssen Pharmaceutica in 1968.[3] Related to other diphenylbutylpiperidine antipsychotics,
pimozide and
fluspirilene, penfluridol has an extremely long elimination half-life and its effects last for many days after single oral dose. Its antipsychotic potency, in terms of dose needed to produce comparable effects, is similar to both
haloperidol and pimozide. It is only slightly
sedative, but often causes
extrapyramidal side-effects, such as
akathisia,
dyskinesiae and pseudo-
Parkinsonism. Penfluridol is indicated for antipsychotic treatment of chronic
schizophrenia and similar
psychotic disorders, it is, however, like most typical antipsychotics, being increasingly replaced by the
atypical antipsychotics. Due to its extremely long-lasting effects, it is often prescribed to be taken orally as tablets only once a week (q 7 days). The once-weekly dose is usually 10–60 mg. A 2006
systematic review examined the use of penfluridol for people with schizophrenia:
Penfluridol compared to typical antipsychotics (oral) for schizophrenia[4]
Summary
Although there are shortcomings and gaps in the data, there appears to be enough overall consistency for different outcomes. The
effectiveness and adverse effects profile of penfluridol are similar to other typical
antipsychotics; both oral and depot. Furthermore, penfluridol is shown to be an adequate treatment option for people with schizophrenia, especially those who do not respond to oral medication on a daily basis and do not adapt well to depot drugs. One of the results favouring penfluridol was a lower drop out rate in medium term when compared to depot medications. It is also an option for people with long-term schizophrenia with residual psychotic symptoms who nevertheless need continuous use of
antipsychotic medication. An additional benefit of penfluridol is that it is a low-cost intervention.[4]
Outcome
Findings in words
Findings in numbers
Quality of evidence
Global state
No marked improvement (CGI) Follow-up: 3 to 12 months
Penfluridol does not clearly change the chance of experiencing 'no marked improvement' when compared with receiving typical antipsychotic drugs. These findings are based on data of low quality.
Global state - needing additional antipsychotic Follow-up: less than 3 months
There is no clear difference between people given penfluridol and those receiving typical antipsychotics. These findings are based on data of low quality.
On average, people receiving penfluridol scored higher than people treated with typical antipsychotics (oral) but there was no clear difference between the groups and this finding is based on data of low quality. The meaning of this in day-to-day care is unclear.
Needing antiparkinsonism medication Follow-up: less than 3 months
There is no clear difference between people given penfluridol and those receiving typical antipsychotics (oral). These findings are based on data of low quality.
There is no clear difference between people given penfluridol and those receiving typical antipsychotics (oral). These findings are based on data of low quality.