Flupenthixol: Uses And Effects Of This Neuroleptic
Neuroleptics or antipsychotics are used to treat disorders such as schizophrenia or other types of psychoses.
In this article we will talk about flupenthixol, a drug that acts as a typical antipsychotic at high doses, although it also acts as a sedative. We will learn about its most important characteristics, its adverse effects and its therapeutic indications, among others.
Flupentixol is a typical antipsychotic drug marketed under brand names such as Depixol and Fluanxol It is a derivative of thioxanthene (a group of classic neuroleptics), along with chlorprothixene and zuclopenthixol.
The pharmaceutical form of flupenthixol (format) is film-coated tablets, usually pink film-coated, round and biconvex.
Mechanism of action
Flupentixol is a high-dose antipsychotic (5 to 20 mg per day). On the other hand, has a weak sedative effect, even with its administration at high doses. It acts, like other neuroleptics, by blocking dopamine receptors; Therefore, dopamine metabolism will increase. This effect may be predominant with respect to the blockade of postsynaptic receptors at low doses.
It is possible that the increased dopamine metabolism explain the positive effect of flupenthixol on mood, as well as its revitalizing effect.
More specifically, flupenthixol has a high degree of affinity with D2 (dopamine) receptors, and a moderate affinity with D1 receptors.
Therapeutic indications
flupenthixol It is indicated for the treatment of chronic schizophrenia and paranoid psychoses with positive symptoms such as hallucinations, paranoid delusions and thought disturbances, accompanied by apathy, anergy and isolation (negative symptoms
It is also indicated in the treatment of mild and moderate depressive disorders, with or without an anxiety component, as well as in the treatment of somatic disorders with a depressive background.
Contraindications
Flupentixol is contraindicated in cases of acute intoxication by alcohol, barbiturates and narcotics, comatose states, excitable or hyperactive patients, since its activating effect can lead to an excess of these characteristics. It is also contraindicated in pregnant women and in women who are lactating.
Warnings and precautions
Flupenthixol should be administered under medical prescription and with a clear and reliable diagnosis, since there is a possibility that it may cause a malignant syndrome in some patients; Therefore, it should be used with caution in patients with a history of seizure syndrome, liver and cardiovascular diseases.
On the other hand, flupenthixol is not recommended for use in children and adolescents, due to the absence of data on safety and efficacy.
Besides, If the patient has been previously treated with other neuroleptics, these should be withdrawn gradually On the other hand, those patients subject to long-term therapeutic treatments have to be evaluated with certain periodicity.
Side effects
Flupentixol may cause drowsiness and a sedative effect; Therefore, it is not advisable to drive during or after taking it. On the other hand, flupenthixol can cause a series of adverse reactions, as occurs with most neuroleptic drugs.
These adverse reactions are extrapyramidal symptoms (during the initial phase of treatment); transient insomnia (especially when the patient has been switched from a sedative neuroleptic), and sedative effect at high doses (occasionally).
In most cases, extrapyramidal symptoms can be satisfactorily controlled by reducing the dose of flupenthixol and/or with antiparkinsonian drugs. However, routine prophylactic use of antiparkinsonian medication is not recommended.
Occasionally and in long-term treatments, tardive dyskinesia may occur Antiparkinsonian drugs do not relieve these symptoms. Dose reduction or discontinuation of treatment is recommended.
Adverse autonomic and cardiovascular effects are very rare, although cases of tachycardia, palpitations and arrhythmias have been described. Dropping blood pressure can result in dizziness.
Overdose
In case of overdose with flupenthixol, the symptoms may involve drowsiness, coma, extrapyramidal symptoms, shock, hypotension, seizures and/or loss of body temperature.
This overdose should be treated with anticholinergic antiparkinsonian drugs if extrapyramidal symptoms occur, with benzodiazepines if agitation or excitement occurs, and with norepinephrine in intravenous saline if the patient is in shock. On the other hand, adrenaline should not be used, as it can cause greater arterial hypotension.
