Delving into the Latest Updates on Flupentixol decanoate with Synapse

Overview

Basic Info

Drug Type

Small molecule drug

Synonyms

Depixol, Fluanxol depot

Target

D2 receptor

Action

antagonists

Mechanism

D2 receptor antagonists(Dopamine D2 receptor antagonists)

Therapeutic Areas

Nervous System Diseases

Active Indication

Schizophrenia

Inactive Indication-

Originator Organization-

Active Organization-

Inactive Organization-

License Organization-

Drug Highest PhaseApproved

First Approval Date-

Regulation-

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Structure/Sequence

Molecular FormulaC33H43F3N2O2S

InChIKeyUIKWDDSLMBHIFT-UHFFFAOYSA-N

CAS Registry30909-51-4

Primary polydipsia affects approximately 11%–20% of patients with chronic schizophrenia, and up to one‐third develop symptomatic hyponatremia. Rapid correction of hyponatremia can precipitate osmotic demyelination syndrome (ODS), involving demyelination in the central pons and extrapontine regions. ODS presenting with severe extrapyramidal symptoms (EPS) in schizophrenia has not been previously documented.

Case Presentation:

A 34‐year‐old man with chronic schizophrenia, maintained on oral olanzapine and monthly flupentixol decanoate, developed polydipsia‐induced hyponatremia. His serum sodium was corrected at 9 mEq/L/day at a local hospital. Ten days later, he presented with fever, cough, dysarthria, dysphagia, and lead‐pipe rigidity. Laboratory tests revealed leukocytosis and rhabdomyolysis without delirium or autonomic instability. Dysarthria and dysphagia were consistent with pseudobulbar palsy. Brain MRI showed T2‐weighted and FLAIR hyperintensities in the bilateral basal ganglia and central pons, confirming ODS. The patient had a favorable clinical course with supportive treatment and regained independent mobility without the need for empirical immunotherapy.

Conclusions:

This case highlights ODS as a rare but critical differential diagnosis for severe EPS in schizophrenia, particularly when presenting with lead‐pipe rigidity and pseudobulbar palsy. Greater awareness of this presentation can facilitate timely diagnosis and appropriate management, avoiding misattribution to antipsychotic‐induced side effects that may result in long‐term morbidity or mortality.

24 Nov 2023·The international journal of neuropsychopharmacology

Schizophrenia Patients Discharged on Clozapine Plus Long-Acting Injectable Antipsychotics From a Public Psychiatric Hospital in Taiwan, 2006–2021

Article

Author: Lin, Ching-Hua ; Lin, Ta-Chun

Abstract:

Background:

Some schizophrenia patients treated with clozapine experience an inadequate response and adherence problems. The purpose of this study was to compare time to rehospitalization within 6 months in schizophrenia patients discharged on 3 clozapine regimens. Additionally, the temporal trend of prescription rate in each group was also explored.

Methods:

Schizophrenia patients discharged from the study hospital from January 1, 2006, to December 31, 2021, (n = 3271) were included in the analysis. The type of clozapine prescribed at discharge was divided into 3 groups: clozapine plus long-acting injectable antipsychotics (clozapine + LAIs), clozapine plus other oral antipsychotics (clozapine + OAPs), and clozapine monotherapy. Survival analysis was used to compare time to rehospitalization within 6 months after discharge among the 3 groups. The temporal trend in the prescription rate of each group was analyzed using the Cochran-Armitage Trend test.

Results:

Patients discharged on clozapine + LAIs had a significantly longer time to rehospitalization than those on clozapine + OAPs or clozapine monotherapy. The prescription rates of clozapine + LAIs and clozapine + OAPs significantly increased over time, whereas the prescription rates of clozapine monotherapy significantly decreased.

Conclusions:

Compared with the clozapine + OAPs group, the clozapine + LAIs group had a lower risk of rehospitalization and a lower dose of clozapine prescribed. Therefore, if a second antipsychotic is required for patients who are taking clozapine alone, LAIs should be considered earlier.

01 Aug 2022·Drugs & aging

An Updated Analysis of Psychotropic Medicine Utilisation in Older People in New Zealand from 2005 to 2019

Article

Author: Nishtala, Prasad S ; Chyou, Te-Yuan

BACKGROUND:

Psychotropic medicine utilisation in older adults continues to be of interest because of overuse and concerns surrounding its safety and efficacy.

OBJECTIVE:

This study aimed to characterise the utilisation of psychotropic medicines in older people in New Zealand.

METHODS:

We conducted a repeated cross-sectional analysis of national dispensing data from 1 January, 2005 to 31 December, 2019. We defined utilisation using the Anatomical Therapeutic Chemical classification defined daily dose system. Utilisation was measured in terms of the defined daily dose (DDD) per 1000 older people per day (TOPD).

RESULTS:

Overall, the utilisation of psychotropic medicines increased marginally by 0.42% between 2005 and 2019. The utilisation increased for antidepressants (72.42 to 75.21 DDD/TOPD) and antipsychotics (6.06-19.04 DDD/TOPD). In contrast, the utilisation of hypnotics and sedatives (53.74-38.90 DDD/TOPD) and anxiolytics decreased (10.20-9.87 DDD/TOPD). The utilisation of atypical antipsychotics increased (4.06-18.72 DDD/TOPD), with the highest percentage change in DDD/TOPD contributed by olanzapine (520.6 %). In comparison, utilisation of typical antipsychotics was relatively stable (2.00-2.06 DDD/TOPD). The utilisation of venlafaxine increased remarkably by 5.7 times between 2005 and 2019. The utilisation of zopiclone was far greater than that of other hypnotics in 2019.

CONCLUSIONS:

There was only a marginal increase in psychotropic medicines utilisation from 2005 to 2019 in older adults in New Zealand. There was a five-fold increase in the utilisation of antipsychotic medicines. Continued monitoring of psychotropic medicine utilisation will be of interest to understand the utilisation of antidepressants and antipsychotic medicines during the coronavirus disease 2019 pandemic year.

100 Deals associated with Flupentixol decanoate

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