of two or more prior episodes of suicidal behavior.4o On flupenthixol decanoate, patients demonstrated significant decreases in suicidal behav-iors compared to the placebo group by the fourth month and sustained the difference through 6 months of treatment. The depot strategy mini-mized the serious problems of patient noncompliance and early study termination. This important study, which has not yet been replicated, strongly supports the continuation of a neuroleptic agent in maintenance treatment of impulsive-behavioral dyscontrol in repeatedly suicidal pa-tients with BPO. With the advent of the atypical neuroleptics, case reports and open label trials have begun to appear concerning efficacy in BPO. In an open label study, c10zapine has been shown to be useful in treating psychotic symptoms in patients with BPO (Psychotic Disorder, not otherwise speci-fied [NOS]), who failed to respond to "three or more standard neurolep-tic trials."zo These 15 patients had recurring delusions or hallucinations that were not typical of schizophrenia, bipolar disorder, or psychotic depression, although 46.7% met criteria for SPO. All had experienced a childhood history of severe and prolonged abuse. Medication trials ranged from 2 to 9 months, with dosages of c10zapine from 75 mg to 550 mg (mean daily dosage 253.3 ± 163.7 mg). Improvement was global (e.g., on the Brief Psychiatric Rating Scale [BPRS], Clinical Global Impression [CGI], Global Assessment Scale [GAS]), with significant changes in both positive and negative psychotic symptoms of the BPRS. Severe chronic self-mutilation in a patient with BPO (refractory to other psychotropic medications) responded rapidly to clozapine 300 mg/ day in one extraordinary case noteworthy for the length of acute

DOI link for of two or more prior episodes of suicidal behavior.4o On flupenthixol decanoate, patients demonstrated significant decreases in suicidal behav-iors compared to the placebo group by the fourth month and sustained the difference through 6 months of treatment. The depot strategy mini-mized the serious problems of patient noncompliance and early study termination. This important study, which has not yet been replicated, strongly supports the continuation of a neuroleptic agent in maintenance treatment of impulsive-behavioral dyscontrol in repeatedly suicidal pa-tients with BPO. With the advent of the atypical neuroleptics, case reports and open label trials have begun to appear concerning efficacy in BPO. In an open label study, c10zapine has been shown to be useful in treating psychotic symptoms in patients with BPO (Psychotic Disorder, not otherwise speci-fied [NOS]), who failed to respond to "three or more standard neurolep-tic trials."zo These 15 patients had recurring delusions or hallucinations that were not typical of schizophrenia, bipolar disorder, or psychotic depression, although 46.7% met criteria for SPO. All had experienced a childhood history of severe and prolonged abuse. Medication trials ranged from 2 to 9 months, with dosages of c10zapine from 75 mg to 550 mg (mean daily dosage 253.3 ± 163.7 mg). Improvement was global (e.g., on the Brief Psychiatric Rating Scale [BPRS], Clinical Global Impression [CGI], Global Assessment Scale [GAS]), with significant changes in both positive and negative psychotic symptoms of the BPRS. Severe chronic self-mutilation in a patient with BPO (refractory to other psychotropic medications) responded rapidly to clozapine 300 mg/ day in one extraordinary case noteworthy for the length of acute

of two or more prior episodes of suicidal behavior.4o On flupenthixol decanoate, patients demonstrated significant decreases in suicidal behav-iors compared to the placebo group by the fourth month and sustained the difference through 6 months of treatment. The depot strategy mini-mized the serious problems of patient noncompliance and early study termination. This important study, which has not yet been replicated, strongly supports the continuation of a neuroleptic agent in maintenance treatment of impulsive-behavioral dyscontrol in repeatedly suicidal pa-tients with BPO. With the advent of the atypical neuroleptics, case reports and open label trials have begun to appear concerning efficacy in BPO. In an open label study, c10zapine has been shown to be useful in treating psychotic symptoms in patients with BPO (Psychotic Disorder, not otherwise speci-fied [NOS]), who failed to respond to "three or more standard neurolep-tic trials."zo These 15 patients had recurring delusions or hallucinations that were not typical of schizophrenia, bipolar disorder, or psychotic depression, although 46.7% met criteria for SPO. All had experienced a childhood history of severe and prolonged abuse. Medication trials ranged from 2 to 9 months, with dosages of c10zapine from 75 mg to 550 mg (mean daily dosage 253.3 ± 163.7 mg). Improvement was global (e.g., on the Brief Psychiatric Rating Scale [BPRS], Clinical Global Impression [CGI], Global Assessment Scale [GAS]), with significant changes in both positive and negative psychotic symptoms of the BPRS. Severe chronic self-mutilation in a patient with BPO (refractory to other psychotropic medications) responded rapidly to clozapine 300 mg/ day in one extraordinary case noteworthy for the length of acute