Flupentixol: A Typical Antipsychotic for Schizophrenia and Depression

Flupentixol, also known by brand names such as Fluanxol, is a typical antipsychotic medication primarily used to treat schizophrenia and psychotic disorders. In lower doses, it is also prescribed to treat mild to moderate depression, particularly when anxiety and low motivation are present. As a thioxanthene derivative, flupentixol belongs to the same class of drugs as other first-generation antipsychotics, offering both antipsychotic and mood-lifting effects depending on dosage.

🧠 Medical Uses of Flupentixol

1. Schizophrenia and Psychotic Disorders
   Flupentixol is mainly used to treat positive symptoms of schizophrenia, such as hallucinations, delusions, paranoia, and thought disorganization. It helps reduce agitation and improve reality perception.

2. Depressive Disorders
   At low doses, flupentixol is used to treat mild-to-moderate depression, especially if symptoms like anxiety, fatigue, or low motivation are present. It’s often prescribed when standard antidepressants aren’t fully effective or when a stimulating effect is needed.

3. Long-Acting Injections (Depot)
   Flupentixol is available in depot (long-acting) injectable form, useful for patients with poor medication adherence. A single injection can last up to two to four weeks, ensuring steady medication levels and reducing relapse risk.

⚙️ How Flupentixol Works

Flupentixol works primarily by blocking dopamine receptors (D1 and D2) in the brain. Dopamine is involved in regulating mood, motivation, and perception. In conditions like schizophrenia, dopamine is often overactive, leading to symptoms like hallucinations and delusions. Flupentixol reduces this overactivity, helping to stabilize thoughts and behavior.

At low doses, flupentixol may actually improve dopamine activity in certain brain areas, offering a mild energizing and mood-enhancing effect, which is why it can help with depression or low energy states.

⚠️ Common Side Effects

As with other first-generation antipsychotics, flupentixol can cause neurological side effects, especially at higher doses. Common side effects include:

• Restlessness (akathisia)

• Stiff muscles or tremors (extrapyramidal symptoms)

• Dry mouth

• Drowsiness or sedation

• Increased appetite and weight gain

• Headache

Serious but less common side effects:

• Tardive dyskinesia (involuntary muscle movements with long-term use)

• Elevated prolactin levels (may cause menstrual irregularities or sexual dysfunction)

• Neuroleptic Malignant Syndrome (NMS) – a rare, potentially fatal reaction involving fever, confusion, and muscle rigidity

❗ Precautions and Warnings

• Not recommended in elderly with dementia-related psychosis due to an increased risk of stroke and death.

• Patients with Parkinson’s disease should avoid this drug as it can worsen motor symptoms.

• Regular monitoring is essential during long-term treatment, particularly for movement disorders.

• Alcohol and other sedatives may enhance sedation and should be avoided.