Zuclopenthixol
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Clinical Pharmacology
Clopixol Depot - antipsychotic (neuroleptic), a derivative of thioxanthene.
Clopixol has a pronounced antipsychotic and specific inhibitory effect. Clopixol may also have a transient, dose-dependent sedative effect, the rapid development of which at the beginning of therapy (before the onset of antipsychotic action) is an advantage in the treatment of acute and sub-acute psychoses.
Tolerance to the nonspecific sedative effect of the drug comes quickly.
Due to the specific inhibitory effect of the drug is especially indicated for agitation, anxiety, hostility or aggressiveness.
The therapeutic effect of Clopixol Depot is significantly more prolonged compared to Clopixol. This allows you to confidently carry out continuous antipsychotic treatment with Clopixol Depot, which is especially important for patients who do not perform medical appointments.
Clopixol depot prevents the development of frequent relapses associated with the voluntary interruption of oral medication by patients.
Indications
Acute and chronic schizophrenia and other psychotic disorders, especially with hallucinations, paranoid delusions and thinking disorders, as well as a state of agitation, increased anxiety, hostility or aggressiveness.
Composition
1 ml of oil solution contains:
active substance: Zuclopenthixol decanoate 200 mg;
excipient: triglycerides
Zuclopenthixol is marketed under different brands and generic names, and comes in different dosage forms:
Brand name | Manufacturer | Country | Dosage form |
---|---|---|---|
Clopixol Depot | Lundbeck AS | Denmark | solution |
Clopixol | Lundbeck AS | Denmark | pills |
Clopixol | Lundbeck AS | Denmark | Other |
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Dosage and Administration
Doses of the drug should be selected individually depending on the patient's condition. As a rule, small doses should initially be used, which are then rapidly increased to the optimal effective level depending on the clinical effect.
Acute attack of schizophrenia, other acute psychotic disorders; pronounced agitation and mania. Usually 10-50 mg / day.
In severe disorders and conditions of moderate severity, the initial dose of 20 mg / day may, if necessary, be increased by 10-20 mg in 2-3 days to 75 mg per day or more.
Chronic psychotic states in schizophrenia and other chronic psychosis. Maintenance dose of 20-40 mg / day.
Agitation in patients with oligophrenia. Usually 6-20 mg / day. If necessary, the dose may be increased to 25-40 mg / day.
Agitation and confusion in patients with senile disorders.. Usually 2-6 mg / day (preferably given in the evening), if necessary, can be increased to 10-20 mg / day.
Adverse reactions
From the nervous system. Extrapyramidal symptoms may develop, especially at the initial stage of treatment. In most cases, they are corrected by reducing the dosages and / or prescription of anti-parkinsonian drugs. However, regular prophylactic use of the latter is not recommended. In rare cases, long-term therapy in patients may develop tardive dyskinesia. Antiparkinsonic drugs do not eliminate its symptoms. A reduction in dosage or, if possible, discontinuation of therapy is recommended.
From the side of mental activity. Drowsiness at the initial stage.
On the part of the autonomic nervous system and the cardiovascular system. Dry mouth, disturbed accommodation, urinary retention, constipation, tachycardia, orthostatic hypotension and dizziness.
Liver. Minor, transient changes in hepatic samples are rarely observed.
Contraindications
Acute poisoning by alcohol, barbiturates, opiates; coma.
Drug interactions
Chemically incompatible combinations not established. Clopixol can increase the sedative effects of alcohol, barbiturates and other central nervous system inhibitors. Clopixol should not be prescribed together with guanethidine and similarly acting means, since antipsychotics can block their hypotensive action. Clopixol can reduce the effectiveness of levodopa and other adrenergic agents, and a combination with metoclopramide and piperazine increases the risk of extrapyramidal symptoms.
Pregnancy and Lactation
Contraindicated. Nursing mothers should stop breastfeeding.
Special instructions
Perhaps the influence of Clopixol on the ability to drive a car and other mechanisms. Therefore, at the beginning of therapy, care must be taken until the patient's response to treatment is determined.
With long-term therapy, it is necessary to carefully monitor patients. With extreme caution, Klopixol should be administered to patients with convulsive disorder, chronic hepatitis and cardiovascular disease.
Clopixol is not recommended to appoint during pregnancy and lactation.
Overdosage
Symptoms: drowsiness, coma, extrapyramidal disorders, convulsions, hypotension, shock, hyper- or hypothermia are possible.
Treatment: in case of taking the drug inside it is necessary to wash the stomach as soon as possible, the use of sorbent is recommended. In the future, conduct symptomatic and supportive therapy. Measures should be taken to support the activity of the respiratory and cardiovascular systems. Do not use epinephrine (adrenaline), because this can lead to a further decrease in blood pressure. Convulsions can be stopped by diazepam, and extrapyramidal symptoms biperidenom.
- Brand name: Clopixol Depot
- Active ingredient: Zuclopenthixol
- Dosage form: Solution for intramuscular injection (oil)
- Manufacturer: Lundbeck AS
- Country of Origin: Denmark
Studies and clinical trials of Zuclopenthixol (Click to expand)
- A randomized controlled double blind study of zuclopenthixol acetate compared to haloperidol in acute psychosis
- Zuclopenthixol and thioridazine in the treatment of aggressive, elderly patients: A double-blind, controlled, multicentre study
- Determination of zuclopenthixol and its main N-dealkylated metabolite in biological fluids using high-performance liquid chromatography with post-column photochemical derivatization and fluorescence detection
- The CYP2D6 genotype predicts the oral clearance of the neuroleptic agents perphenazine and zuclopenthixol*
- HPLC-ESI-MS/MS determination of zuclopenthixol in a fatal intoxication during psychiatric therapy
- Voltammetric investigation of oxidation of zuclopenthixol and application to its determination in dosage forms and in drug dissolution studies
- The development of Clinical Guidelines for the use of Zuclopenthixol Acetate
- Comparative study of the pharmacokinetics of zuclopenthixol decanoate and fluphenazine decanoate
- Serum concentrations and clinical effect of zuclopenthixol in acutely disturbed, psychotic patients treated with zuclopenthixol acetate in Viscoleo®
- Zuclopenthixol levels in serum and breast milk
- Zuclopenthixol decanoate in schizophrenia: Serum levels and clinical state
- Milk concentrations of flupenthixol, nortriptyline and zuclopenthixol and between-breast differences in two patients
- Hypouricemic effect of zuclopenthixol: a potential marker of drug compliance?
- Serum levels and clinical response in long-term pharmacotherapy with zuclopenthixol decanoate
- Maintenance therapy with zuclopenthixol decanoate: associations between plasma concentrations, neurological side effects andCYP2D6genotype
- A pharmacoeconomic evaluation of zuclopenthixol compared with haloperidol and risperidone in the treatment of schizophrenia
- Characterisation of zuclopenthixol metabolism by in vitro and therapeutic drug monitoring studies
- Neuroleptic malignant syndrome during zuclopenthixol therapy in X-linked cerebral adrenoleukodystrophy
- The Potential Role of Zuclopenthixol Acetate in the Management of Refractory Hyperactive Delirium at the End of Life
- Zuclopenthixol facilitates memory retrieval in rats: possible involvement of noradrenergic and serotonergic mechanisms
- Treatment of manic episodes: Zuclopenthixol and Clonazepam versus Lithiim and Clonazepam
- HPLC-DAD and HPLC-MS Findings in a Fatality Involving (Z)-cis-Clopenthixol (Zuclopenthixol)
- Refractory schizophrenia treated with clozapine combined with zuclopenthixol
- Economic evaluation of zuclopenthixol acetate compared with injectable haloperidolin schizophrenic patients with acute psychosis