once daily perphenazine

[heyjack70]

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Anyone ever dose perphenazine once daily. My thoughts are that patients who are semi stabilized on this med, but often miss doses due to disorganization would benefit from a consolidated dosing time.

I know the half life is about 12 hours, but my understanding is that the anti-psychotic effect is not simply due to the immediate D2 blockade, but likely due to alterations of DNA transcription/RNA translation, and that even once daily dosing would likely be effective.

 

[whopper]

The theory is it isn't specifically the D2 blockage but the second messengers systems affected by the D2 blockage, so after the D2 blockage stopped, the second messengers may still be doing their thing hours after the med came off the receptor.

I found an article on it though it's rather dated.
http://ajp.psychiatryonline.org/article.aspx?articleID=174638

It also explains (in part) why some meds work better than Haldol despite that med being very strongly D2 blocking and other meds like Clozaril not binding onto D2 receptors working better.

Personally, I'd stay away from typicals as a first-line treatment due to a plethora of new data from the last ten years showing that they cause free-radical damage and neurodegeneration to the brain, but I emphasize first-line. For some, it's one of the only meds that work.

 

[vistaril]

Anyone ever dose perphenazine once daily. My thoughts are that patients who are semi stabilized on this med, but often miss doses due to disorganization would benefit from a consolidated dosing time.

I know the half life is about 12 hours, but my understanding is that the anti-psychotic effect is not simply due to the immediate D2 blockade, but likely due to alterations of DNA transcription/RNA translation, and that even once daily dosing would likely be effective.

yeah I dose perphenazine once daily sometimes.

 

[DebDynamite]

Me too. We have a very limited formulary in the prison where I recently worked and dosing @ HS seemed to be best for a couple of my patients.