Typical Depot Research Articles

A study of the fire risk value in transporting and storing petroleum products at a tank depot

The goal is to determine the individual fire risk at the stages of transportation and storage of petroleum products on the example of a typical oil depot in Irkutsk region and to develop measures aimed to reduce the likelihood of leakage of petroleum products and limit the impact of fire and explosion hazards. The research objects are probabilities of adverse fire-related events (the block diagram method was used) and individual fire risks (the regulatory methods were used). Using the event tree method and taking into account the standards requirements, the probability of accident development scenarios was calculated. Consequences of fire-related emergencies were predicted. The calculated distributions of individual fire-related risks at oil products storage facilities made it possible to identify areas of maximum danger for the personnel. The dangers when unloading railway tanks, storing petroleum products in tanks RVS-2000 and filling automobile tanks were investigated. The parameters of negative events were calculated following possible emergency scenarios for the personnel. The distribution of damage probabilities caused by dangerous fire and explosion-related factors at the production site for the most probable emergency scenarios than can develop at railway tanks on a railway overpass, a group of tanks RVS-2000 and automobile tanks was studied. The fire risk value was calculated at each point of the tank farm. Measures aimed to reduce the risk to the personnel in hazardous areas were suggested.

Clinical outcomes following switching antipsychotic treatment due to market withdrawal: a retrospective naturalistic cohort study of pipotiazine palmitate injection (Piportil Depot) discontinuation, subsequent acute care use and effectiveness of medication to which patients switched.

Introduction:Pipotiazine palmitate depot injection (Piportil) was withdrawn from the UK marketplace in 2015. Few studies exist on the clinical impact of such market withdrawal. Purpose: We aimed to identify a cohort of patients switching from pipotiazine following this withdrawal and explore factors associated with effectiveness of the medication switched to and subsequent acute service use.Methods:A naturalistic retrospective cohort study was conducted in Sussex, United Kingdom. Those discontinuing pipotiazine solely due to market withdrawal were identified from electronic patient database and manual searching. Multivariate logistic regression analyses and survival analyses were performed to explore associations between available baseline variables and dichotomous all-cause discontinuation of the next prescribed medication and admission to acute mental health services over the subsequent year.Results:Of 205 patients identified as receiving pipotiazine in October 2014, 137 switched from this due to market withdrawal. Over the subsequent year, 31.5% discontinued the medication to which they were switched and 19% required acute care. Drug class switched to (typical depot vs atypical long acting injection (LAI) vs atypical oral) had no significant association with discontinuation. Switch to atypical LAI was significantly associated with acute care in comparison to typical depot. Those with a schizophrenia diagnosis were significantly less likely to discontinue switched medication or to receive acute care in comparison to those with schizoaffective disorder. Women were significantly more likely to discontinue switched medication than men. Of those requiring acute care, only 38% had required this in the previous 2 years.Conclusions:Antipsychotic market withdrawal has demonstrable negative clinical implications and requires careful clinical management. Increased acute care rates in those receiving an atypical LAI versus a typical depot following pipotiazine suggests lower effectiveness or possible withdrawal effects. No significant difference between depots, LAIs and oral medications on discontinuation supports the importance of a collaborative, fully informed approach when deciding next treatment options.

Tackling myths of common prescribing patterns in schizophrenia amongst Egyptian psychiatrists

BackgroundThere is limited data related to how psychiatrists actually choose amongst different medications, especially in Egypt. Our aim was to survey a sample of psychiatrists regarding common patterns of antipsychotic prescribing practices and review how these vary from the evidence-based. We conducted a qualitative, cross-sectional survey of 124 psychiatrists of different grades from hospitals across Cairo, Egypt. Questions were asked to elicit attitudes towards common antipsychotic prescribing practices and the use of treatment guidelines in schizophrenia.ResultsA total 77.4% participants said they would prescribe atypical antipsychotics as first-line treatment if cost were not an issue, 42.7% said they commonly add anticholinergics from the start with antipsychotics, 50% said they would maintain patients on anticholinergics for as long as they were receiving antipsychotics, 93.5% said they commonly or in some situations combine typical depot antipsychotics with oral atypical antipsychotics, 88.7% said they commonly or in some situations use antipsychotics in small doses for sedation, and 55.6% sometimes add a mood stabilizer to enhance the effect of antipsychotic drugs. Using logistic regression, physician grade significantly predicted whether participants commonly add anticholinergic medication from the start with antipsychotics (p = 0.001). Age and gender significantly predicted whether participants sometimes add a mood stabilizer to enhance the effect of antipsychotics (p < 0.05).ConclusionsWe demonstrated that several antipsychotic prescribing practices were not evidence-based, yet appeared to be prevalent in a large proportion of participants. A number of demographic and psychiatrist-related factors predicted certain prescribing patterns.

Static and dynamic structural features of single pellets determine the release behaviors of metoprolol succinate sustained-release tablets

The multiple-unit sustained-release (MUSR) dosage forms containing numerous sustained-release subunits present a reliable choice for oral formulation of controlled release systems. As a typical MUSR, the metoprolol succinate sustained-release tablet is an advanced system with limited researches devoted to relating its structure to the drug release phase other than the preparation process and modulation to the release behaviors. This research details a three-dimension method to image the internal structure and detail drug release features of commercial metoprolol succinate sustained-release tablets and component individual single pellets. As such, a new perspective for MUSR dosage form is provided. Using high energy synchrotron radiation X-ray microcomputed tomography (SR-μCT), the in-situ structure parameters were obtained nondestructively. It was demonstrated that the average number of spherical pellets in a tablet was 853 ± 12 (n = 3). The average volume of the pellets was 0.09 ± 0.01 mm3, the diameter was 0.55 ± 0.03 mm, and the sphericity was 0.87 ± 0.06. These data reflected the numerical features of pellets in MUSR tablets, which were helpful for reverse engineering to MUSR. Based on the three dimensional model generated by image processing and analysis software, the pellet structures were divided into three layers of typical depot sustained release system: pellet core, drug-containing layer and outer film. The dynamic structural features determined refer to the changes of structures in pellets during in vitro drug release, with evidence that the coating layer on the pellets maintained a spherical morphology whilst numerous valleys appeared on the surface. The material constitution and distribution in coating layer were evaluated by synchrotron radiation-based Fourier transform infrared mapping and results indicated a composition of hydroxypropyl methylcellulose dispersed in ethyl cellulose. Knowledge of these structural characteristics confirmed that the mechanism of sustained drug release was membrane controlled and consistent with the drug release profiles. In conclusion, the structural investigation provided knowledge of the intrinsic quality of metoprolol succinate sustained-release tablets and offers guidance for reverse engineering of MUSR.

Research on the Optimizing Model and Solving Algorithm of Assignment Plan of CRH-Emu Depot's Repair Tracks

China Railway High-speed is expanding into a large network that covers most of the middle scale cities. To manipulate the China Railway High-speed Electric Multiple Unit (CRH-Emu) train's daily inspection and repair, 45 CRH-Emu depots were established in China. Depots are equipped with several special tracks to carry out the inspection and repair. With the repair workload's rising, the number of repair-function tracks is becoming bottleneck of depots' repair capacity. In order to improve the efficiency of CRH-Emu depot's repair tracks, this paper established an integer model, with the minimal unnecessary idle time of repair tracks as the objective function, and with back-departure depot time, and the repair demand of CRH-Emu as both operational and repair constraints, the matching relationship between CRH-Emu and tracks as the track occupation constraint. To reduce the model scale, a track occupation topological graph was constructed. Based on the graph, MAX-MIN ant system was applied to obtain optimal result. By the example of solving a typical depot's tracks utilization scheme, the model and optimization method were proved to be effective. Finally, a further discussion of software for scheduling the plan was given.

PMH30 - Treatment Persistence and Discontinuation Risk of Typical Depot and Atypical Long-Acting Antipsychotics in Patients with Schizophrenia in Poland

PMH30 - Treatment Persistence and Discontinuation Risk of Typical Depot and Atypical Long-Acting Antipsychotics in Patients with Schizophrenia in Poland

Risperidone (depot) for schizophrenia.

This is a copy of an article published in the Cochrane Database of Systematic Reviews © 2016 Cochrane Collaboration Publications. © The Author(s). http://www.cochranelibrary.com/

Indication of depot antipsychotic treatment in the view of slovak psychiatrists

With the increasing number of atypical antipsychotics in depot form, there emerges question about plus and cons of their use in schizophrenia patients. We focused on the opinion of Slovak psychiatrists about use of this treatment in some specific situations of schizophrenia treatment. Research was realized via questionnaire on psychiatrists (n = 47) from ambulant and hospital care, during one conference in June 2015. First part of the questionnaire was focused on the preference of oral or depot form of antipsychotic treatment. Depot form would be indicated by psychiatrists (in more than 89%) when low compliance, anosognosia or frequent episodes. On the contrary, oral antipsychotic treatment is preferred in young patients or employed patients. The type of symptoms (e.g. positive, negative) has relatively small impact on the preference of treatment, where the preferences of each type were the lowest (fewer than 36%). According to the opinion of psychiatrists, depot antipsychotic treatment is not suitable in first episode of disorder (according to 81% of respondents), otherwise in second or third episode it would not be chosen by 6% of asked psychiatrists.From the aspects of the choice between atypical or typical depot, atypical antipsychotics in depot form were favored when presence of adverse reactions (80%), occurrence of negative symptoms (65%) and short duration of disorder (58%). Typical depot was preferred by psychiatrists in patients with chronic states.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Stimulation of mitochondrial oxidative capacity in white fat independent of UCP1: A key to lean phenotype

We are facing a revival of the strategy to counteract obesity and associated metabolic disorders by inducing thermogenesis mediated by mitochondrial uncoupling protein-1 (UCP1). Thus, the main focus is on the adaptive non-shivering thermogenesis occurring both in the typical depots of brown adipose tissue (BAT) and in UCP1-containing cells that could be induced in white adipose tissue (WAT). Because contribution of WAT to resting metabolic rate is relatively small, the possibility to reduce adiposity by enhancing energy expenditure in classical white adipocytes is largely neglected. However, several pieces of evidence support a notion that induction of energy expenditure based on oxidation of fatty acids (FA) in WAT may be beneficial for health, namely: (i) studies in both humans and rodents document negative association between oxidative capacity of mitochondria in WAT and obesity; (ii) pharmacological activation of AMPK in rats as well as cold-acclimation of UCP1-ablated mice results in obesity resistance associated with increased oxidative capacity in WAT; and (iii) combined intervention using long-chain n-3 polyunsaturated FA (omega 3) and mild calorie restriction exerted synergism in the prevention of obesity in mice fed a high-fat diet; this was associated with strong hypolipidemic and insulin-sensitizing effects, as well as prevention of inflammation, and synergistic induction of mitochondrial oxidative phosphorylation (OXPHOS) and FA oxidation, specifically in epididymal WAT. Importantly, these changes occurred without induction of UCP1 and suggested the involvement of: (i) futile substrate cycle in white adipocytes, which is based on lipolysis of intracellular triacylglycerols and re-esterification of FA, in association with the induction of mitochondrial OXPHOS capacity, β-oxidation, and energy expenditure; (ii) endogenous lipid mediators (namely endocannabinoids, eicosanoids, prostanoids, resolvins, and protectins) and their cognate receptors; and (iii) AMP-activated protein kinase in WAT. Quantitatively, the strong induction of FA oxidation in WAT in response to the combined intervention is similar to that observed in the transgenic mice rendered resistant to obesity by ectopic expression of UCP1 in WAT. The induction of UCP1-independent FA oxidation and energy expenditure in WAT in response to the above physiological stimuli could underlie the amelioration of obesity and low-grade WAT inflammation, and it could reduce the release of FA from adipose tissue and counteract harmful consequences of lipid accumulation in other tissues. In this respect, new combination treatments may be designed using naturally occurring micronutrients (e.g. omega 3), reduced calorie intake or pharmaceuticals, exerting synergism in the induction of the mitochondrial OXPHOS capacity and stimulation of lipid catabolism in white adipocytes, and improving metabolic flexibility of WAT. The role of mutual interactions between adipocytes and immune cells contained in WAT in tissue metabolism should be better characterised. This article is part of a Special Issue entitled Brown and White Fat: From Signaling to Disease.

The Research Based on RBF Neural Network in the Power of Prediction of Grain Depot

According to the fact that the use of electricity in grain depot is nonlinear time series, the article introduces the prediction model of electricity based on Radial Basis Function Neural Network, and conducts the modeling and prediction by adopting the historical electricity consumption of a typical grain depot. As the result of simulation shows, the model obtains better forecasting results in grain depot electricity.

P-1284 - Analysis of one-year prescription of antipsychotics and rate of rehospitalizations in patients with schizophrenia spectrum disorders in slovakia

Introduction Schizophrenia is a disorder with chronic course and a need of a long-term antipsychotic treatment to prevent rehospitalizations. Objectives To find a possible association between treatment with different types of antipsychotics and rate of rehospitalizations in patients with schizophrenia spectrum disorders. Aims To analyze the rate of rehospitalizations in groups of patients treated with typical, atypical and depot antipsychotics. Methods Data of 1400 patients discharged from hospitalization in 2010 with ICD-10 diagnoses F20.x were obtained from the General Health Insurance Company which covers the majority of the population with chronic mental disorders in Slovakia. The structure of patients according to age and sex represented the whole adult population hospitalized with diagnoses F20.x in Slovakia. Results 27.4% of patients had 1 to 8 readmissions after the index discharge from hospitalization in the same year. 29347 prescriptions of psychopharmacological drugs were registered for 499886 patient/days in outpatient settings. 14781 prescriptions for antipsychotics consisted of 67.3% prescriptions for p.o. atypical antipsychotics, 16.9% for p.o. typical antipsychotics, 11.5% for atypical depots and 4.2% prescriptions for typical depots. No statistically significant association between prescriptions of particular group of antipsychotics (typical, atypical, depot) and the occurrence of at least one rehospitalization was found. Conclusions No association between prescription of certain type of antipsychotic and probability of rehospitalization based on analyses of prescriptions rate could not reflect the clinical reality properly. Further analyses with consideration of dosage, combinations of antipsychotics and rate of prescriptions for individual patient should be done.

Using ultrasonography in evaluating the intramuscular injection techniques used for administering drug treatments to schizophrenic patients in Japan

This study was conducted with six patients with schizophrenia, four of whom received the atypical antipsychotic risperidone long-acting injectable (RLAI), and two patients receiving the typical depot injection (TDI). The purpose of this study was to determine the location (gluteus medius or maximus; deltoid muscles) and diffusion of typical and atypical antipsychotic medications administered intramuscularly using ultrasonography. When using the standardized depth of needle insertion, in some cases, the drug was injected into the gluteus maximus instead of the gluteus medius. Similarly, in some cases the TDI was not visible in the ultrasonographic images until sixteen days after the injection. This verifies how hard the injection site becomes when microspheres of RLAI is injected as compared to other muscle areas. These results confirmed that the gluteus muscle structure was the ideal muscle for depot injection as evidenced by the injection solution being dispersed and rendered not visible immediately after intramuscular injection (IM). With the use of ultrasonography, injection sites and drug dispersions were evaluated under a direct visual guidance, suggesting that ultrasonography is a useful method for establishing evidence for determining correct insertion of IM injection, diffusion of medications, and the effective administration of IM injections.

Treatment patterns and clinical characteristics prior to initiating depot typical antipsychotics for nonadherent schizophrenia patients

BackgroundNonadherence with antipsychotic medication is an important clinical and economic problem in the treatment of schizophrenia. This study identified treatment patterns and clinical characteristics that immediately precede the initiation of depot typical antipsychotics in the usual treatment of schizophrenia patients with a recent history of nonadherence with oral antipsychotic regimens.MethodsData were drawn from a large, multisite, 3-year prospective noninterventional observational study of persons treated for schizophrenia in the United States, which was conducted between 7/1997 and 9/2003. The analytical sample included patients who, in the 6 months prior to enrollment, were considered nonadherent with oral antipsychotics and were not treated with depot antipsychotics (N = 314). Patients who were subsequently initiated on typical depots during the 3-year follow-up were compared with patients who continued therapy with only oral antipsychotic agents. Group comparisons were made on patient baseline characteristics and precedent variables that were assessed 1 to 6 months prior to depot initiation. Patient assessments were made at predetermined intervals throughout the 3-year study using standard psychiatric measures, a patient-reported questionnaire, and medical record information.ResultsA small proportion of patients (12.4%) who were recently nonadherent with oral antipsychotics were subsequently initiated on depot therapy during the 3-year study. Compared to patients treated with only oral antipsychotics, those subsequently initiated on a depot were significantly more likely to be hospitalized at depot initiation or the previous 30 days, to have recent involvement with the criminal justice system (arrests), recent illicit drug use, recent switching or augmentation of oral antipsychotics, and recent treatment with oral typical antipsychotics.ConclusionDespite prior nonadherence with oral antipsychotic medication, only a small proportion of nonadherent schizophrenia patients were initiated on depot antipsychotics in this 3-year prospective study. Patients subsequently initiated on depot had a more severe treatment pattern and clinical profile immediately preceding depot initiation. This profile may have triggered the decision to initiate a depot. Findings have important clinical and economic ramifications for practitioners, policy makers, and other decision makers, highlighting the need for early identification of and tailored therapeutics for schizophrenia patients with a history of nonadherence with their recent oral antipsychotic regimens.

Cost-Utility Analysis of Treatment with Olanzapine Compared with Other Antipsychotic Treatments in Patients with Schizophrenia in the Pan-European SOHO Study

To determine the cost utility of treating schizophrenic patients with olanzapine compared with other antipsychotics in a naturalistic outpatient setting. The pan-European SOHO study is a 3-year, prospective, outpatient, observational study of outcomes associated with antipsychotic treatment, focusing on olanzapine, in ten European countries. For the cost-utility analysis, healthcare resource use (inpatient care, day care, outpatient psychiatric consultations and antipsychotic and concomitant medication use) and EQ-5D data were collected at baseline and at 3, 6 and 12 months. The perspective was that of the health service payer. UK healthcare unit costs (year 2004 values) were applied to the resource use data for the ten countries. UK population tariffs were applied to the EQ-5D data to determine utility values.An Epoch analysis was used to analyze the longitudinal data. Multivariate regression analyses that adjusted for baseline covariates were used to estimate the incremental cost and utility gains for patients treated with olanzapine compared with each of the other antipsychotics (risperidone, quetiapine, amisulpride, clozapine and oral or depot typical antipsychotics). A total of 10 972 patients were enrolled at baseline, of which 9107 completed the 12-month study period. Treatment with olanzapine was more effective in terms of QALYs gained than all of the other antipsychotic treatments. Treatment with olanzapine dominated quetiapine and amisulpride. The incremental cost for olanzapine compared with risperidone was pound sterling 226 per patient over 12 months and the incremental cost per QALY gained was pound 5156, with bootstrap analyses showing 100% of the replications falling below a pound sterling 30 000 per QALY gained threshold. Compared with treatment with clozapine, olanzapine was found to be marginally more effective, at an additional cost of pound sterling 13 per patient over 12 months and to have an incremental cost per QALY gained of pound sterling 775. Bootstrap analyses showed that 81% of replications fell below a pound sterling 30 000 per QALY gained threshold. Comparing olanzapine with oral and depot typical antipsychotics, the incremental cost was pound sterling 849 and pound sterling 1106 per patient over 12 months and the incremental cost per QALY gained was pound sterling 15 696 and pound sterling 23 331, respectively. Bootstrap analyses showed that 98% of the replications fell below a pound sterling 30 000 per QALY gained threshold for the comparison with oral typical antipsychotics, and 79% of replications for the comparison with depot preparations. Among SOHO patients, if a funding threshold of pound sterling 30 000 per QALY gained is assumed, this analysis suggests that olanzapine has a high probability of being the most cost-effective treatment compared with other antipsychotic treatments. However, comparison of olanzapine with clozapine and typical depot antipsychotics should be viewed with caution because clozapine is a second-line treatment and depot treatment is used for patients who do not adhere to their oral medication.

Adjuvant Regulates Antigen-Specific Helper T Cell Evolution (B27)

Abstract Antigen-specific helper T cells are the cognate regulators of multiple developmental checkpoints in adaptive immunity. Importantly, TCR-pMHCII interactions also control the evolution of antigen-specific Th cells in ways that remain poorly understood. Here, we demonstrate that typical depot producing adjuvants drive clonal dominance through the action of their adjuvant vehicle. In contrast, non-depot adjuvants re-set the selection threshold to propagate clones expressing high affinity TCR. Furthermore, oil in water formulations that readily disperse antigen-adjuvant aggregates in vivo also impact the magnitude of clonal expansion and substantially exaggerate the penetrance of high affinity clones. Finally, reducing antigen dose does not impact the affinity threshold for clonal selection arguing against a mechanism driven by inter-clonal competition in vivo. These findings reveal vaccine adjuvants as critical regulators of a TCR affinity-based clonal selection mechanism that underpins the evolution of adaptive immunity.

Report on hazardous household waste generation in Japan

Surveys of over 2000 households in Japan were conducted to investigate the characteristics of hazardous household waste (HHW) generation. In Japan, about 2.5 to 4.3 kg of HHW are produced per tonne of the residential waste stream. The percentage of used batteries in HHW was over 50%. Every household using spray (aerosol) cans had more than seven cans on average. The generation of HHW, in terms of both quantities and type of waste produced, appeared to vary with dwelling type. Detached dwelling residents tended to store HHW such as used batteries, whereas apartment residents tended not to store waste. The amounts of discarded HHW were larger at the end of the year in comparison with other months. The data accumulated were used to estimate the quantities of HHW disposed off annually, and the quantities and type of waste that might be received by a typical depot collection programme in Japan.

Differing Effects of Antipsychotic Medications on Substance Abuse Treatment Patients with Co‐occurring Psychotic and Substance Abuse Disorders

This retrospective study of patients treated in a ninety-day, inpatient, dual-diagnosis treatment program examined antipsychotic effectiveness in this population using length of stay in treatment and successful program completion as outcome measures. All patients with co-occurring substance dependence and schizophrenia or schizoaffective disorder treated with olanzapine, risperidone, ziprasidone, and typical depot neuroleptics from January 2001 to December 2003 (N = 55) are the subjects of this study. Patients stayed longer in treatment when taking risperidone (82 +/- 19 days) or ziprasidone (74 +/- 21 days) compared with olanzapine (44 +/- 30 days) or typicals (47 +/- 36 days). Eighty-eight percent of risperidone patients and 64% of ziprasidone patients successfully completed the program, while only 33% of olanzapine patients and 40% of patients on typicals successfully completed the program. Risperidone and ziprasidone were associated with significantly better program performance than olanzapine or depot typicals in this population. Possible reasons for this difference are discussed.

Antipsychotic treatment and extrapyramidal symptoms amongst schizophrenic inpatients

Extrapyramidal symptoms (EPS) are seen in 50–75% of patients treated with typical antipsychotics and are a cause of treatment failure in at least 30% of the patients. Using atypical antipsychotics, the EPS incidence is lower, but a low-dosage strategy using typical antipsychotics is also known to cause fewer EPS. What conclusions can be drawn for the daily clinical practice? A naturalistic study including all schizophrenic inpatients in a psychiatric ward (n=123) analysed the effects of treatment concerning positive/negative symptoms, EPS, number of days to re-hospitalization and inpatient-days in the year after baseline admittance, using atypical and typical antipsychotics as recommended by the Danish Society of Psychiatry. The incidence of EPS was significantly higher in patients who were treated with typical antipsychotics in relation to atypical antipsychotics (46% vs. 12%, P<0.001). Patients with EPS had significantly more negative symptoms and a poorer level of function at discharge. Nevertheless, no difference regarding re-hospitalization and inpatient-days was found, whether the patient was treated with typical or atypical antipsychotics. However, it is important to underline that patients treated with atypical oral antipsychotic do as well as patients on typical depot antipsychotics.

Atypical neuroleptics in the treatment of aggression and hostility in schizophrenic patients

The treatment of aggressive symptoms in schizophrenic patients is a relevant clinical problem. We systematically review the efficacy of the different atypical neuroleptics on acute or persistent aggressive symptoms also regarding methodological problems. Currently typical neuroleptics are still first choice in treating acute aggressive symptoms, while risperidone and olanzapine could be alternatives. In persistent aggression clozapin shows the best specific results. Typical depot neuroleptics should be considered in cases when medication compliance is a problem.

An audit of psychiatric case notes in relation to antipsychotic medication and information giving.

This paper reports upon a Welsh Office funded "clinical effectiveness" project. The project aimed to produce evidence-based practice guidelines for depot neuroleptic medication. An audit was conducted to establish current practice regarding the provision of illness and treatment specific information to out-patients and their informal carers. Sixty-five patients' case-notes, under the care of a single community mental health team were examined for evidence of the type, nature and frequency of information given to patients receiving typical depot neuroleptic medications. Service guidelines were produced and are presented.