Flupenthixol (flupentixol)

Flupenthixol (flupentixol) is a prescription medicine used in the treatment of schizophrenia. It may also be used to treat depression and bipolar disorder. It alters the thoughts and elevates the mood, improving the person's ability to think, feel and behave.

Flupenthixol (flupentixol) is a typical antipsychotic. It works by blocking the action of dopamine, a chemical messenger in the brain that affects thoughts and mood.

• Schizophrenia: Used for treatment of schizophrenia and other psychoses, particularly with apathy and withdrawal but not mania or psychomotor hyperactivity.
• Depression: Used for short-term symptomatic treatment of mild to moderate depression (with or without anxiety).

SSRIs & related anti-depressant drugs

Thioxanthene Antipsychotic

Flupentixol is a low dose neuroleptic of the thioxanthene group. In low doses (up to 3 mg/day) flupentixol has an anxiolytic, antidepressive and mood stabilizing effect and certain activating properties. It acts mainly through a blockage of central monoamine receptors, especially in the dopaminergic system.

Flupentixol blocks postsynaptic dopamine receptors in the CNS to inhibit dopamine-mediated effects.

Adult Dose (Oral):

• Psychoses: Initial: 3-9 mg bid, adjusted according to response; Max: 18 mg daily.
• Depression (with/without anxiety): Initial: 1 mg daily; after 1 week increased to 2 mg daily; Max: 3 mg daily (last dose not later than 4 p.m.).

Adult Dose (IM):

• Psychoses (Decanoate): Initial: 20 mg test dose; after 7 days, 20-40 mg every 2-4 weeks; Maintenance: 50 mg every 4 weeks to 300 mg every 2 weeks.

Elderly Dose: Initial dose: ¼ or ½ of the usual initial dose.

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Flupenthixol may be taken with or without food, but it is better to take it at a fixed time.

If you miss a dose of Flupenthixol, take it as soon as possible; however, if it is almost time for your next dose, skip the missed dose.

Common Side Effects:

• Sleepiness
• Orthostatic hypotension
• Dry mouth
• Abnormality of voluntary movements
• Weight gain
• Increased prolactin level in blood
• Urinary retention
• Constipation
• Muscle stiffness
• Tremor

Precautions:

• Flupenthixol may decrease alertness, affect vision or make you feel sleepy and dizzy; do not drive if these symptoms occur.
• Take at bedtime to avoid feeling sleepy during the day.
• Avoid alcohol (can make drowsiness worse).
• Inform doctor if any abnormal movements, particularly of the face, lips, jaw and tongue occur.
• May increase weight, blood sugar and cholesterol; monitor regularly.
• Don't stop taking without talking to your doctor first.
• Caution in hepatic, renal, cardiovascular, cerebrovascular or respiratory disease.

Contraindications:

• Hypersensitivity
• Extremely excitable and overactive patients
• Mania
• Porphyria
• Coma
• Pre-existing CNS depression
• Bone marrow suppression
• Phaeochromocytoma
• Lactation

Drug Interactions:

• Drugs with antimuscarinic effects (TCAs): May potentiate adverse effects.
• Levodopa: Reduced efficacy.
• Dopamine antagonists (metoclopramide, prochlorperazine): Increases adverse extrapyramidal symptoms.
• Potentially Fatal: Potentiates CNS effects of alcohol, general anaesthetics, hypnotics, anxiolytics and opioids; blocks antihypertensive effect of guanethidine.

Food Interactions: It is unsafe to consume alcohol with Flupenthixol.

Use in Pregnancy: May be unsafe; animal studies have shown harmful effects; doctor will weigh benefits and potential risks.

Use in Lactation: Probably unsafe; limited data suggests drug may pass into breastmilk and harm the baby.

Pediatric Use: Not recommended for children.

Geriatric Use: Elderly dose: 0.5 mg daily (oral); 6.25 mg test dose (IM); increase with caution.

Renal Impairment: Limited information available; consult your doctor.

Hepatic Impairment: Use with caution; dose adjustment may be needed.

Overdose: Symptoms of intoxication by melitracen (anticholinergic nature) dominate; gastric lavage and activated charcoal; support respiratory and cardiovascular systems; do not use adrenaline; treat convulsions with diazepam and extrapyramidal symptoms with biperiden.

Storage: Store at a temperature not exceeding 30 degree C in a dry place. Protect from light. Keep out of reach of children.

Flupenthixol