***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A six-month evaluation of penfluridol , a long-acting oral preparation , was conducted with 50 severely ill schizophrenic patients . After an initial three-month stabiization period , the patients were divided into two equal groups and a double-blind evaluation of penfluridol versus placebo was conducted . The results of this study indicate that weekly administration of penfluridol ( one oral dose ) provides relatively safe and adequate control of severely ill schizophrenic patients  and displays efficacy similar to that of the shorter-acting antipsychotic agents . If these results are confirmed by other clinical investigators , this medication may prove to be of invaluable help in maintaining the schizophrenic patient in his community Fifty‐six out of 60 schizophrenic patients completed a double‐blind study of two long‐acting neuroleptics , penfluridol ( peroral ) and flupenthixol decanoate ( parenteral ) . Half of the patients were on maintenance . therapy of flupenthixol prior to the study , the other half on penfluridol . The actual double‐blind study ( 12 weeks ) was commenced after a preliminary period of 4 weeks , the patients in the two main groups being r and omly divided into two further groups , one continuing the medication unchanged , the other changing to the alternative drug The authors estimated components of variance and intraclass correlation coefficients ( ICCs ) to aid in the design of complex surveys and community intervention studies by analyzing data from the Health Survey for Engl and 1994 . This cross-sectional survey of English adults included data on a range of lifestyle risk factors and health outcomes . For the survey , households were sample d in 720 postal code sectors nested within 177 district health authorities and 14 regional health authorities . Study subjects were adults aged 16 years or more .  ICCs and components of variance were estimated from a nested r and om-effects analysis of variance . Results are presented at the district health authority , postal code sector , and household levels . Between-cluster variation was evident at each level of clustering . In these data , ICCs were inversely related to cluster size , but design effects could be substantial when the cluster size was large . Most ICCs were below 0.01 at the district health authority level , and they were mostly below 0.05 at the postal code sector level . At the household level , many ICCs were in the range of 0.0 - 0.3 . These data may provide useful information for the design of epidemiologic studies in which the units sample d or allocated range in size from households to large administrative areas Penfluridol , a member of the novel diphenylbutylpiperidine class of antipsychotic drugs , is the first long-acting oral neuroleptic . The population of the present study consisted of 24 chronic schizophrenic patients ( 14 males , ten females ) whose treatment with penfluridol was initiated in our previous open/double-blind trial lasting 32 weeks 1 ; mean age was 42.2 years and mean duration of illness , 15.4 years . During one additional year in an uncontrolled clinical study , penfluridol in the form of 20-mg capsuent procedures included BPRS , CGI , NOSIE , vital signs , and laboratory measurements . During this long-term treatment with penfluridol , the scores of a cluster of BPRS items that included emotional withdrawal , conceptual disorganization , motor retardation , uncooperativeness , and blunted affect showed a progressively significant improvement . This indicated that the Bleulerian primary symptoms in chronic schizophrenics can be improved by the long-term administration of this long-acting neuropleptic with concomitant betterment of social adaptation and activity . The percentage of failure was very low ( four patients ) and was marked by instability of psychopathology with periods of excitation . The incidence of extrapyramidal reactions necessitating the administration of an antiparkinsonian drug during the length of trial was 35 per cent . No serious effects nor significant laboratory test changes were observed Five depot neuroleptics ( fluphenazinedeconoate , fluspirilene , pipothiazinepalmitate , penfluridol and perphenazine-enanthate ) were compared based on clinical trials in subacute and chronic schizophrenic patients . The psychopathological symptoms were documented by means of the AMP-system . Statistical analyses showed several differences between the effects of the five substances . The AMP-system proved a useful instrument to differentiate similar drugs The authors discuss the historical aspects , as well as the various etiological and clinical factors which contribute to the so-called pharmacogenically induced depressions during treatment by means of neuroleptics generally , and long-term neuroleptics especially . An open study on 161 schizophrenic patients treated by means of fluspirilene and 123 patients treated by means of penfluridol  is described . A single blind trial on 48 patients , by means of fluphenazine-decanoate and flupenthixol-decanoate , which compares the possible depression-inducing or antidepressant activity of the above drugs , is presented . The criteria for evaluating drug-induced depressions and their two clinical types are discussed During an open clinical trial , 51 schizophrenic patients were treated with  Penfluirdol  , 34 for 1 year and 17 for a shorter time . The mean dosage of Penfluirdol was 22 up to 28 mg per week . Assessment s were made on days 0 , 14 , 28 , 56 , 90 , 180 , 270 , and 365 using the AMP system and the EPRS scale of Simpson and Angus . The symptomatology was mainly reduced during the first 3 months of treatment and remained afterwards relative unchanged . Penfluridol showed a good antipsychotic effect on productive schizophrenic symptoms ( thought disorders and paranoid symptoms , autism and schizophrenic affective disorders ) . The dosage used showed only a slight sedative effect and was well tolerated concerning autonomic and extrapyramidal side-effects Twenty‐two hospitalized schizophrenic patients , participating in a large‐scale phase II double‐blind dose‐effect study ( 30 , 60 , and 120 mg weekly ) of penfluridol , a new diphenylbutylpiperidine neuroleptic , were maintained on a regular dosage regimen for 13 wk . Several blood sample s were taken during the last dosage interval . Results show that the peak concentration develops within 12 hr after the last dose . A rapid decline , probably due to tissue re‐equilibration , then occurs and is followed by a much slower falloff . Detectable concentrations 168 hr after administration are consistent with the long duration of action of penfluridol . Statistically significant differences between doses were found in the analysis of variance of plasma concentrations at all sampling times and in mean steady‐state plasma concentrations . Wide differences in plasma concentrations were noted in patients receiving the same absolute dose , but a good relationship was defined between mean steady‐state concentration and the dose expressed as mg per either kg of body weight or square meter of body surface area Twenty‐one female schizophrenics ( age range 34–74 years ) were included in a clinical study assessing the effectiveness of penfluridol as a basic maintenance therapy . At the start of the study , the patients , all of whom had been successfully maintained on penfluridol for at least 6 months , were divided into two comparable groups . Group I ( ten patients ) received penfluridol and Group II(II patients ) placebo under double‐blind conditions for 6 months . Patients were evaluated using a 36‐item question naire , which was completed before and after 1 , 3 , 4 and 6 months of treatment Penfluridol , a diphenylbutylpiperidene derivative , is a new long acting neuroleptic , administered orally , once weekly . It is marketed in several European countries and has been used successfully in the treatment of various acute psychoses , for severely ill chronic schizophrenic patients , and as maintenance therapy for chronic schizophrenic patients . The present study was design ed to compare , in a double-blind fashion , the efficacy of penfluridol and fluphenazine decanoate  in the maintenance therapy of schizophrenic out patients A double blind comparative study was conducted to evaluate the efficacy and safety of penfluridol and trifluoperazine in patients of chronic schizophrenia .  Penfluridol was administered once weekly while trifluoperazine was administered twice daily by preparing identical capsules . The data revealed that both the compounds were similarly effective in maintaining control of symptoms of chronic schizophrenia . However , penfluridol has a definite advantage over trifluoperazine since it is administered once a week instead of twice a day Sixty patients meeting the criteria established for schizophrenia who attained a clinical plateau following hospital discharge were r and omized to receive for one year either penfluridol , 20 to 160 mg orally once each week , or fluphenazine decanoate , 0.5 to 4 ml every two weeks . The relapse rate for both treatments was low and equal . The rate of recurrence of psychosis for patients receiving  penfluridol was 7 % and for those receiving fluphenazine decanoate 10 % . A retrospective comparison of the  penfluridol  group was made to a similar group of patients assigned to placebo in an earlier study . Placebo-treated patients had a relapse rate of 68 % . Penfluridol patients had statistically fewer psychotic relapses . Questions about the possible carcinogenicity of penfluridol in animals will have to be resolved before it can be widely used . This study demonstrates the feasibility of using an oral , long-acting antipsychotic agent . It would be a useful psychopharmacologic addition in the treatment of outpatient schizophrenics Penfluridol is a diphenylbutylpiperdine derivative with a half-life of sixty-six ( 66 ) hours . The present study was design ed to determine its efficacy for the maintenance of schizophrenia . In a 52 week double-blind study , once weekly doses of penfluridol were compared with once daily doses of chlorpromazine in 56 schizophrenic patients receiving maintenance treatment on an outpatient basis . Both drugs were similar in their clinical effectiveness ; no major side effects occurred with either drug A double‐blind , 6‐month trial of penfluridol and placebo was conducted in 15 chronic psychotic patients in the age range of 25–64 years . The patients , who had been well controlled with penfluridol for several months , were divided into two comparable groups with seven patients receiving penfluridol  and eight receiving  placebo . Dexetimide and other non‐psychotropic drugs already taken before the trial were continued . Each patient was assessed before and after 1 , 2 , 4 and 6 months of treatment using a 36‐item question naire . At the end of the trial , the weekly dosage of the double‐blind medication was two tablets of 20 mg or placebo in all patients . Whereas penfluridol‐treated patients maintained their improvement , placebo‐treated patients by the end of the trial had significantly deteriorated as regards direct psychotic phenomena and general behaviour BACKGROUND A recent review suggested an association between using unpublished scales in clinical trials and finding significant results . AIMS To determine whether such an association existed in schizophrenia trials . METHOD Three hundred trials were r and omly selected from the Cochrane Schizophrenia Group 's Register . All comparisons between treatment groups and control groups using rating scales  were identified . The publication status of each scale was determined and cl aims of a significant treatment effect were recorded . RESULTS Trials were more likely to report that a treatment was superior to control when an unpublished scale was used to make the comparison ( relative risk 1.37 ( 95 % CI 1.12 - 1.68 ) ) . This effect increased when a ' gold-st and ard ' definition of treatment superiority was applied ( RR 1.94 ( 95 % CI 1.35 - 2.79 ) ) . In non-pharmacological trials , one-third of ' gold-st and ard ' cl aims of treatment superiority would not have been made if published scales had been used . CONCLUSIONS Unpublished scales are a source of bias in schizophrenia trials Plasma levels of penfluridol and thiothixene were studied after 4 weeks treatment in a double-blind controlled trial of 47 patients suffering from chronic schizophrenic syndromes . There was found a tenfold variation in plasma levels for penfluridol , and about a twentyfold variation for thiothixene . For penfluridol , a significant correlation between dosage and plasma level and also between dosage and changes in psychopathology as regards factor 5 in the Märtens & Jonsson S scale which comprises the items most characteristic of a schizophrenic syndrome , was found . For thiothixene , a significant correlation between plasma levels and changes in factor 5 was found . A gas-chromatographic method for penfluridol is also described To comprehend the results of a r and omised controlled trial ( RCT ) , readers must underst and its design , conduct , analysis , and interpretation . That goal can be achieved only through total transparency from authors . Despite several decades of educational efforts , the reporting of RCTs needs improvement . Investigators and editors developed the original CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to help authors improve reporting by use of a checklist and flow diagram . The revised CONSORT statement presented here incorporates new evidence and addresses some criticisms of the original statement . The checklist items pertain to the content of the Title , Abstract , Introduction , Methods , Results , and Discussion . The revised checklist includes 22 items selected because empirical evidence indicates that not reporting this information is associated with biased estimates of treatment effect , or because the information is essential to judge the reliability or relevance of the findings . We intended the flow diagram to depict the passage of participants through an RCT . The revised flow diagram depicts information from four stages of a trial ( enrollment , 
    Output:
    
The efficacy 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 chronic sufferers of 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