Fluphenazine Resistant Psychosis

Abstract

A fifty year old female chronic schizophrenic was admitted to hospital following a relapse of her psychosis. She had previously responded well to treatment with trifluoperazine but because of her history of medication non-compliance, a trial of fluphenazine enanthate was instituted. Despite the close chemical similarity between trifluoperazine and fluphenazine the patient failed to respond to the latter in either its oral or depot intramuscular form. Although it is not unusual for a patient to respond to one antipsychotic and not to another, the above case of intra-class non-responsiveness is indeed rare and not readily explained. We present this unusual case and discuss some possible explanations.