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Highlights

Flupenthixol
Flupenthixol is a potent, relatively non-sedating, neuroleptic drug of the thioxanthene class. In low to moderate dosages (up to 100mg/2 weeks) flupenthixol is non-sedating, while a sedative effect may be expected when higher doses are administered. Flupenthixol shows antipsychotic effects in patients with schizophrenia. It may be of benefit in patients with flat or depressed affect. In low doses, Psytixol possesses disinhibiting and mood elevating properties. Flupenthixol dose-dependently increases the serum prolactin levels. The decanoic acid esterification of flupenthixol results in the slow release of the drug from the oily solution at the injection site with consequent prolongation of duration of action. The onset of action usually occurs in the range of 24 to 72 hours after injection and the improvement of symptoms continues for two to four weeks. A pre-injection serum concentration of 2-8 nmol/L is recommended for maintenance treatment of schizophrenic patients with a low - moderate degree of illness. However, there is considerable variation in the individual response of patients to flupenthixol decanoate and its use for maintenance therapy requires careful supervision. The maximal serum concentration is reached at the end of the first week after injection. Estimates of half-life varied considerably between studies; elimination is prolonged, in the order of three weeks to three months and probably reflects release of the active compound from the depot.

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