Flupentixol


Flupentixol, also known as flupenthixol, marketed under brand names such as Depixol and Fluanxol is a typical antipsychotic drug of the thioxanthene class. It was introduced in 1965 by Lundbeck. In addition to single drug preparations, it is also available as flupentixol/melitracen—a combination product containing both melitracen and flupentixol.
Flupentixol is not approved for use in the United States. It is, however, approved for use in the UK, Australia, Canada, Russian Federation, South Africa, New Zealand, Philippines and various other countries.

Medical uses

Flupentixol's main use is as a long-acting injection given once in every two or three weeks to individuals with schizophrenia who have poor compliance with medication and suffer frequent relapses of illness, though it is also commonly given as a tablet. There is little formal evidence to support its use for this indication but it has been in use for over fifty years.
Flupentixol is also used in low doses as an antidepressant. There is tentative evidence that it reduces the rate of deliberate self-harm, among those who self-harm repeatedly.

Adverse effects

Adverse effect incidence
;Common adverse effects include:
;Uncommon adverse effects include:
;Rare adverse effects include:
;Unknown incidence adverse effects include:
It should not be used concomitantly with medications known to prolong the QTc interval as this may lead to an increased risk of QTc interval prolongation. Neither should it be given concurrently with lithium as it may increase the risk of lithium toxicity and neuroleptic malignant syndrome. It should not be given concurrently with other antipsychotics due to the potential for this to increase the risk of side effects, especially neurological side effects such as neuroleptic malignant syndrome. It should be avoided in patients on CNS depressants such as opioids, alcohol and barbiturates.

Contraindications

It should not be given in the following disease states:

Pharmacodynamics

Binding profile
Proteincis-flupentixoltrans-flupentixol
5-HT1A8028—
5-HT2A87.5 —
5-HT2C102.2 —
mAChRsNeg.Neg.
D13.5474
D20.35120
D31.75162.5
D466.3>1000
H10.865.73

Acronyms used:

HFC — Human frontal cortex receptor

MB — Mouse brain receptor

RC — Cloned rat receptor
Its antipsychotic effects are likely caused by D2 and/or 5-HT2A antagonism, whereas its antidepressant effects at lower doses may be mediated by preferential D2/D3 autoreceptor blockade, resulting in increased postsynaptic activation.

Pharmacokinetics