Flupentixol – Antipsychotic and Antidepressant Therapy

Flupentixol is an antipsychotic medication (neuroleptic) belonging to the thioxanthene derivative group. The drug possesses a unique spectrum of pharmacological activity, combining potent antipsychotic, specific antidepressant, and activating (disinhibiting) effects. Its mechanism of action is due to the selective blockade of dopamine receptors (predominantly D1 and D2), as well as serotonin 5-HT2 receptors in the brain, allowing it to effectively target a wide range of psychopathological symptoms.

A notable feature of flupentixol is its dose-dependent effect. At low doses, it acts as a potent antidepressant and anxiolytic, promoting improved mood and sociability, while higher doses exhibit classic antipsychotic action aimed at controlling delusions and hallucinations. Due to its stimulating component, the drug is particularly effective in treating patients with apathy, reduced initiative, and depressive-anxious states. Flupentixol is available in both tablet form for daily use and as an oil-based solution (depot) for long-term release, ensuring stable symptom control over several weeks and improving treatment adherence in patients with chronic psychosis.

The drug is taken orally or administered intramuscularly. Treatment requires careful dose selection to minimize the risk of developing extrapyramidal disorders.

Wikipedia page
Flupentixol

Indications

Flupentixol is indicated for the treatment of a wide range of mental disorders in adults:

  • Schizophrenia and Psychoses: treatment of hallucinatory, delusional states and thought disorders, especially in the presence of apathy and withdrawal.
  • Depressive States: mild to moderate depression accompanied by anxiety, asthenia, and lack of initiative.
  • Psychosomatic Disorders: asthenic conditions and neurotic disorders related to stress.
  • Maintenance Therapy: prevention of relapse in chronic psychotic illnesses (in depot form).

Dosage and administration

The flupentixol dosing regimen is strictly individualized and depends on the clinical presentation of the illness.

  • For Depression and Anxiety: the starting dose is usually 1 mg once daily in the morning. If necessary, the dose is increased to 2-3 mg.
  • Antipsychotic Therapy: dosage can range from 3 mg to 15 mg or more per day, divided into several doses.
  • Depot Forms: injections are usually administered once every 2–4 weeks at a dose of 20–40 mg.
  • Administration Method: tablets are taken orally with water. Evening intake is not recommended for doses below 3 mg due to the possible stimulating effect.
  • Missed Dose: the missed dose should be taken as soon as possible unless it is time for the next one. Do not double the dosage.

The use of flupentixol is restricted in the following clinical cases:

  • Hypersensitivity: allergy to flupentixol or other components of the medication.
  • Acute CNS Depression: comatose states, acute poisoning with alcohol, opioids, or barbiturates.
  • Parkinson's Disease: due to the risk of worsening motor function.
  • Cardiovascular Disorders: severe hypotension, recent myocardial infarction, or rhythm disturbances (QT interval prolongation).
  • Pregnancy and Lactation: use is only permissible in cases of absolute necessity under strict medical supervision.

Side effects of flupentixol are often transient and depend on the dose level:

  • Extrapyramidal Symptoms: tremor, muscle rigidity, akathisia (restlessness), especially at higher doses.
  • Nervous System: insomnia (due to the activating effect), drowsiness, or dizziness.
  • Autonomic Reactions: dry mouth, blurred vision, constipation, and urinary retention.
  • Cardiovascular: orthostatic hypotension (blood pressure drop when standing) and tachycardia.
  • Metabolism: increased prolactin levels, which may lead to menstrual cycle changes or gynecomastia.
  • General Symptoms: changes in appetite and body weight.

Frequently Asked Questions

Flupentixol is a potent antipsychotic (neuroleptic) belonging to the thioxanthene group. It works by blocking dopamine receptors in the brain, which helps eliminate delusions and hallucinations. A unique feature of this substance is its ability, at low doses, to exert activating and antidepressant effects, improving mood and increasing a patient's overall activity level.
This substance has a biphasic action. At low doses (typically up to 3 mg per day), it acts as an antidepressant and stimulant, helping with apathy and anxiety. At higher doses (above 3–5 mg), its primary antipsychotic effect emerges, which is necessary for treating schizophrenia and other psychoses. The dosage is determined solely by a physician based on the specific diagnosis.
Like many neuroleptics, flupentixol can cause extrapyramidal disorders, such as muscle rigidity, hand tremors, restlessness, or involuntary movements. The risk of these effects is higher with high doses. If such symptoms appear, a doctor may prescribe specific corrective medications or adjust the dosage.
Flupentixol in its "depot" form (an oil-based solution for intramuscular injection) is a long-acting medication. A single injection provides a slow and steady release of the substance into the bloodstream over 2 to 4 weeks. This is ideal for maintenance therapy, as it removes the need for daily tablet intake and reduces the risk of disease relapse.
Flupentixol enhances the effects of alcohol and other central nervous system depressants, so alcohol consumption is strictly discouraged. Additionally, at the start of therapy or when increasing the dose, drowsiness and slowed reaction times may occur, making driving or operating dangerous machinery risky.

List of medicines by active substance

-18%
Anxino 0.5 mg / 10 mg Everest
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Everest

Anxino

Flupentixol + Melitracen
0.5 mg / 10 mg 50 tablets
398₴ 486₴
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