Some aspects of the French contribution during the past ten years to the study and use of injectable long-acting neuroleptics.

Out of five injectable long-acting neuroleptics (LANs) in general use in France, two are french derivatives. LANs in France have been introduced at high dosages, because of the administration of high doses of oral activating neuroleptics at that time. Despite the apparent lack of relationship between dosage and adverse effects, the clinical use of LANs has nowadays moved to lower doses, probably because of the treatment of a greater proportion of less severely-ill outpatients and of patients at an early stage. The "sectorial" organization of community psychiatry in France has contributed to the low-dose LAN strategy. French authors pointed to an original indication of LANs, namely very low dosages in chronic alcoholism characterized by a high frequency of early personality disorders, such as paranoid or psychopathic traits. Adverse reactions are more pronounced in such patients at high dosages, esp. depression and sedation. The authors have been the first ones to report the incidence of depressive reactions in prolonged treatments with LANs (1967). Malignant hyperthermia, though rare, has been related to a direct onset of treatment with a LAN and not to its dosage.