Fludipen 0.5

Indications

Flupenthixol (also spelled Flupentixol) is an antipsychotic medicine. It is used:

• At low doses by mouth, for short-term treatment of depression, especially with anxiety, low energy or lack of motivation. In this use it is often combined with Melitracen.
• At higher doses, or as a long-acting injection, for schizophrenia and other psychoses.

How It Works

Flupenthixol acts on chemical messengers in the brain, mainly dopamine. At low doses it can lift mood and reduce anxiety; at higher doses it blocks dopamine receptors and reduces symptoms such as hallucinations and disturbed thinking.

Dosage and Administration

• Depression and anxiety (adults): usually 1 mg once a day in the morning. The doctor may increase this to 2 mg a day after a week. Doses above 2 mg a day only as prescribed. The last dose should be taken before 4 pm because it can disturb sleep. Elderly people usually start with 0.5 mg a day.
• Schizophrenia and psychosis: tablets or long-acting injection, as prescribed. The injection is given into a muscle by a doctor or nurse, usually every 2 to 4 weeks.
• Not for children.

If there is no improvement in depression within one week, the doctor may stop it. Do not stop suddenly after long use.

Interactions

It can add to the drowsiness caused by alcohol, sleeping tablets, strong painkillers and antihistamines. Avoid combining it with other medicines that affect heart rhythm, such as Amiodarone, Sotalol, Erythromycin, Citalopram and Haloperidol, unless a doctor advises. It can weaken the effect of Levodopa and other Parkinson's medicines. Lithium and Metoclopramide may increase the risk of movement side effects. Tell the doctor about all antidepressants you take.

Contraindications

• Allergy to flupenthixol or other thioxanthene medicines.
• Severe drowsiness, coma or collapse of the circulation.
• Phaeochromocytoma (a rare adrenal tumour).
• Low-dose use is not suitable for people who are very agitated or overactive.

Side Effects

Common: restlessness, difficulty sleeping, dry mouth, constipation, dizziness, headache, weight gain and blurred vision. At higher doses: tremor, muscle stiffness and slow movements. Long-term use can cause uncontrolled movements of the face, tongue or limbs (tardive dyskinesia).

Get urgent medical help for high fever with muscle stiffness, sweating and confusion (a rare reaction called neuroleptic malignant syndrome), fainting or a fast or irregular heartbeat, a fit, yellow skin or eyes, painful swelling of a leg or chest pain with breathlessness, or new or worsening thoughts of harming yourself.

Pregnancy and Lactation

Use in pregnancy only if a doctor decides it is needed. If used late in pregnancy, the newborn may have restlessness, stiffness, breathing or feeding problems. Small amounts pass into breast milk; use while breastfeeding only if the doctor advises.

Precautions and Warnings

• In elderly people with dementia, antipsychotics increase the risk of stroke and death; it is not used for behaviour problems in dementia.
• Take care with heart disease, epilepsy, Parkinson's disease, liver or kidney disease, glaucoma, enlarged prostate, thyroid disease and diabetes.
• It may cause drowsiness or restlessness; do not drive until you know how it affects you.
• Avoid alcohol.
• Do not stop suddenly after long-term use; reduce gradually as advised.

Overdose

Overdose can cause severe drowsiness, coma, stiffness, low blood pressure, fits and heart rhythm problems. It is an emergency; get urgent medical help.

Therapeutic Class

Antipsychotic (thioxanthene group).

Storage

Store tablets below 30°C in a dry place, away from light. Injections are kept and given by healthcare staff. Keep out of reach of children.