Flupenthixol, depot

Across the sites, an average of 15% of inpatients received depot antipsychotic drugs (Sim etal, 2004b). This was most common in Singapore (75%) followed by Taiwan (20%), Japan and China (6%). The depot antipsychotic drugs used were fluphenazine decanoate, flupenthixol decanoate, zuclopenthixol decanoate, haloperidol decanoate, pipothiazine palmitate, and fluphenazine enanthate. 

Quraishi S, David A. Depot flupenthixol decanoate for schizophrenia or other similar psychotic disorders. Cochrane Database Syst Rev 1999. Issue 4. 

The intramuscular administration of antipsychotics acting for weeks prevents this independent action and improves compliance on the other hand, only highly potent antipsychotics such as fluphenazine, flupenthixol and haloperidol are suitable for depot administration and it is precisely these medicines that lead more frequently to EPS and dysphoric mood (van Putten et al, 1984). 

Wistedt B. A depot neuroleptic withdrawal study. A controlled study of the clinical effects of the withdrawal of depot fluphenazine decanoate and depot flupenthixol decanoate in chronic schizophrenic patients. Acta Psychiatr Scand 1981 64(l) 65-84. 

An Indian patient receiving depot fluphenazine (50 mg every three weeks) for schizophrenia, and with mild parkinsonian tremor controlled with procyclidine 5 mg twice daily, developed marked rigidity, bradykinesia and jaw tremor when he began to chew areca. The symptoms were so severe he could barely speak. When he stopped chewing areca his stiffness and abnormal movements disappeared. Another patient receiving depot flupenthixol developed marked stiffness, tremor and akathisia, despite taking... 

When the occurrence of flip-flop kinetics is not recognised it may compromise the interpretation of results from studies on the pharmacokinetic behaviour of slow release dosage forms. Flip-flop pharmacokinetics may occur with any extravascularly administered parenteral slow release dosage form. Intramuscular depot injectimis of antipsychotics such as fluphenazine decanoate, haloperidol decanoate or flupenthixol decanoate show this behaviour. It also occurs after the administration of oral slow release products of active substances such as isoxuptine, carbamazepine, diclofenac, valproic acid, morphine and theophylline. 

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