Schizophrenia flupenthixol

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

Johnson DAW, Ludlow JM, Street K, et ai. Double-blind comparison of half-dose and standard-dose flupenthixol decanoate in the maintenance treatment of stabilised outpatients with schizophrenia. Br J Psychiatry 1987 151 634-638. 

The results of 11 studies in 1933 patients with schizophrenia, who were randomly assigned to amisulpride (n = 1247), haloperidol (n = 309), risperidone (n = 113), flupenthixol (n = 62), or placebo (n = 202) have been reviewed (45). Extrapyramidal signs occurred in 15% of those given amisulpride (n = 579), 12% of those given risperidone (n = 113), and 31% of those given haloperidol (n = 214). In contrast, endocrine disorders were more frequent with amisulpride (4%) and risperidone (6%) than with haloperidol (1%). In a subgroup of patients with predominant negative schizophrenia who had at... 

Thioxanthenes are used in the treatment of psychosis, including schizophrenia, senile psychosis, pathological jealousy, and borderline personality disorder. Other uses include the treatment of pain, postoperative neuralgia, sedation, anxiety neurosis, childhood behavior problems, and depression. The maximum therapeutic daily oral dose for chlorprothixene, flupenthixol, and thiothixene is 600, 224, and 60 mg respectively the maximum intramuscular dose of each is 200 mg day 100 mg weekly, and 30 mg dayrespectively. Some thioxanthenes and thioxanthenones have shown signs in mice and in vitro assays of possible human therapeutic potential against tumors, and some thioxanthenes have been shown to have cytotoxic and antimicrobial activities. 

Figure 3.2 Efficacy of a- and f-flupenthixol in schizophrenia. The a-isomer caused a greater improvement in symptomatology than placebo while the f-isomer was without antipsychotic efficacy. Source Reproduced with permission from Johnstone et al. 1978.

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... 

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