Flupenthixol: uses and effects of this neuroleptic.

An antipsychotic of the typical neuroleptic group used for some cases of schizophrenia.

Neuroleptics or antipsychotics are used for the treatment of disorders such as schizophrenia or other types of psychosis.

In this article we will discuss flupenthixola 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.

Flupenthixol: characteristics

Flupenthixol is a typical antipsychotic drug marketed under brand names such as Depixol and Fluanxol.. It is a derivative of thioxanthene (a group of classical neuroleptics), along with chlorprothixene and zuclopenthixol.

The pharmaceutical form of flupenthixol (format) is film-coated tablets, usually pink, round and biconvex.

Mechanism of action

Flupenthixol is an antipsychotic at high doses (5 to 20 mg per day). On the other hand, it has a weak sedative effecteven at high doses. It acts, like other neuroleptics, by blocking dopamine receptors; it will therefore increase dopamine metabolism. This effect may be predominant with respect to the blockade of postsynaptic receptors at low doses.

It is possible that the increase in dopamine metabolism may explain the positive effect of flupenthixol on mood, as well as its revitalizing effect.

More specifically, flupenthixol has a high degree of affinity for D2 (dopamine) receptors and a moderate affinity for D1 receptors.

Therapeutic indications

Flupenthixol is indicated for the treatment of chronic schizophrenia and paranoid psychoses with positive symptoms such as hallucinations, paranoid delusions and thought disturbances 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 anxiety component, as well as in the treatment of somatic disorders with depressive background.

Contraindications

Flupenthixol 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 lactating women.

Warnings and precautions

Flupenthixol should be administered under a doctor's prescription and with a clear and reliable diagnosis, as there is a possibility that it may lead to malignant syndrome It should therefore be used with caution in patients with a history of convulsive syndrome, hepatic 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.

In addition, if the patient has been previously treated with other neuroleptics, these should be withdrawn gradually.. On the other hand, patients undergoing long-term therapeutic treatment should be evaluated periodically.

Side effects

Flupenthixol can cause drowsiness and a sedative effect; therefore it is not recommended to drive during or after taking it. On the other hand, flupenthixol can cause a number of adverse reactions, as is the case 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 with flupenthixol dose reduction and/or antiparkinsonian drugs. However, routine prophylactic use of antiparkinsonian medication is not recommended.

Occasionally and in long-term treatment, tardive dyskinesia may occur. Antiparkinsonian drugs do not alleviate these symptoms. Dose reduction or discontinuation of treatment is recommended.

Autonomic and cardiovascular adverse effects are very rare, although cases of tachycardia, palpitations and arrhythmias have been described. A drop in Blood Pressure may result in dizziness.

Overdose

In case of overdose with flupenthixol, the symptomatology may involve somnolence, coma, extrapyramidal symptoms, shock, hypotension, convulsions and/or loss of body temperature. and/or loss of body temperature.

This overdose should be treated with anticholinergic antiparkinsonian drugs if extrapyramidal symptoms are present, with benzodiazepines if agitation or excitement is present, and with noradrenaline in intravenous saline if the patient is in shock. On the other hand, adrenaline should not be used, as it may cause further arterial hypotension.

Bibliographic references:

• Stahl, S.M. (2002). Essential psychopharmacology. Neuroscientific bases and clinical applications. Barcelona: Ariel.
• Flupentixol. (2015). Vademecum. Flupenthixol data sheet. (2017). Ministry of Health, Social Policy and Equality.