Overview
Flupentixol is a thioxanthene derivative antipsychotic medication used primarily for the treatment of schizophrenia and other psychotic disorders. It has both antipsychotic and antidepressant properties, with the decanoate formulation providing long-acting depot administration for maintenance therapy.
Mechanism of Action
Flupentixol acts as a dopamine D1 and D2 receptor antagonist in the central nervous system, with additional antagonistic effects at serotonin 5-HT2A receptors. This dual mechanism provides both antipsychotic and mood-stabilizing effects.
Indications
- Schizophrenia
- Psychotic disorders
- Depression with anxiety (low-dose formulations)
- Maintenance therapy for chronic psychotic conditions
Dosage
Oral: Initial dose 1 mg 2-3 times daily, maintenance 3-6 mg daily in divided doses. Depot injection (decanoate): 20-40 mg every 2-4 weeks, adjusted based on response. Maximum oral dose: 18 mg daily.
Contraindications
- Hypersensitivity to flupentixol or thioxanthenes
- Comatose states
- CNS depression from alcohol, barbiturates, or opioids
- Parkinson's disease
- Severe cardiovascular disease
- Phaeochromocytoma
Side Effects
- Extrapyramidal symptoms (dystonia, akathisia, parkinsonism)
- Sedation
- Weight gain
- Dry mouth
- Constipation
- Blurred vision
- Tardive dyskinesia
- Neuroleptic malignant syndrome
- QT prolongation
- Hyperprolactinemia
- Orthostatic hypotension
Interactions
- CNS depressants (alcohol, opioids, benzodiazepines) - additive sedation
- Anticholinergic drugs - increased anticholinergic effects
- QT-prolonging drugs (antiarrhythmics, certain antibiotics) - increased arrhythmia risk
- Levodopa - reduced efficacy
- Antihypertensives - enhanced hypotensive effects