Chlorprothixen
When using any antipsychotic, there is a risk of developing neuroleptic malignant syndrome (hyperthermia, muscle rigidity, fluctuations in consciousness, instability of the autonomic nervous system).
Patients with pre-existing psychoorganic syndrome, mental retardation, as well as those who abuse opiates and alcohol make up a significant proportion of deaths.
Treatment
: withdrawal of antipsychotic. Symptomatic therapy and general supportive treatment measures. Dantrolene and bromocriptine may be effective. After taking antipsychotics by mouth, symptoms may persist for more than one week.
Acute attacks of glaucoma due to pupil dilation can occur in patients with the rare shallow anterior chamber syndrome and in patients with a narrow anterior chamber angle.
Due to the risk of malignant arrhythmias, Chlorprothixene should be used with caution in patients with a history of cardiovascular disease and in patients with a family history of long QT interval (see section "Caution").
Before starting treatment, an ECG examination should be performed.
The use of the drug Chlorprothixene is contraindicated if the QTc interval at the initial measurement exceeds 450 ms in men and 470 ms in women (see section "Contraindications"). During treatment, the need for ECG monitoring should be assessed on an individual basis. During the treatment period, the dose should be reduced if the QT interval increases, and therapy should be discontinued if the QTc interval is >500 ms.
It is recommended to periodically monitor water and electrolyte balance indicators.
The simultaneous use of other antipsychotic drugs should be avoided (see section "Interaction with other drugs").
Like other antipsychotics, Chlorprothixene should be used with caution in patients with psychoorganic syndrome, seizures, liver, kidney and cardiovascular diseases in the later stages, as well as patients with myasthenia gravis and benign prostatic hyperplasia.
Caution must be exercised
when using the drug in patients with:
- pheochromocytoma,
- prolactin-dependent tumors,
- severe arterial hypotension or orthostatic dysregulation,
- Parkinson's disease,
- diseases of the hematopoietic system,
- hyperthyroidism,
- urinary disorders, urinary retention,
- pyloric stenosis (pyloric stenosis), intestinal obstruction (see section “With caution”).
Like other psychotropic drugs, Chlorprothixene may affect blood glucose levels in patients with diabetes mellitus, which may require dose adjustment of antidiabetic drugs (insulin or oral hypoglycemic drugs).
Patients undergoing long-term treatment, especially with high doses, are subject to careful monitoring over time with periodic assessment of the need to reduce the maintenance dose.
Cases of venous thromboembolism (VTE) have been reported while taking antipsychotic drugs. Due to the fact that patients treated with antipsychotic drugs are often at risk for developing VTE, risk factors for VTE should be identified before and during treatment with chlorprothixene and precautions taken.
It has been reported that antipsychotics with α-adrenergic blocking effects may cause priapism; it is possible that chlorprothixene also has this property. If severe priapism occurs, medical intervention may be required. Patients should be warned about the need to urgently seek medical help if objective and subjective signs of priapism appear.
Use of the drug in children and adolescents under 18 years of age
Chlorprothixene is not recommended for use in children and adolescents. A sufficient number of clinical studies aimed at studying the effectiveness and safety of the use of chlorprothixene for the treatment of children and adolescents have not been conducted.
Elderly patients
Cerebrovascular adverse reactions
According to randomized placebo-controlled trials in populations of patients with dementia, the use of some atypical antipsychotics was associated with an approximately 3-fold increase in the risk of cerebrovascular adverse reactions. The mechanism by which this risk increases is unknown. A similar increase in risk cannot be excluded for other antipsychotics and other patient groups. In patients with risk factors for stroke, Chlorprothixene should be used with caution (see section "With caution").
Elderly patients are especially at risk of developing orthostatic hypotension.
Increased mortality in older patients with dementia
Data from two large observational studies showed that older patients with dementia taking antipsychotic drugs had a nonsignificant increased risk of death compared with patients not taking antipsychotic drugs. There is no sufficient data to accurately assess the magnitude of the risk and the reasons for its increase.
Chlorprothixene is not registered for the treatment of behavioral disorders in elderly patients with dementia.
To avoid the development of withdrawal syndrome, it is necessary to stop treatment with Chlorprothixene gradually.
Excipients
Chlorprothixene tablets contain lactose monohydrate. Patients with rare hereditary lactose intolerance, lactase deficiency or glucose-galactose malabsorption should not take this drug.
Chlorprothixene and alcohol forum. #32 Nerve Cell
Sent
Please help me figure it out! My grandmother has been on antidepressants, antipsychotics and sleeping pills for a long time. When she was in the neurosis department and then discharged home, she bought a mountain of prescription pills and took them. She lay there like a zombie for days, crawling out only to take pills. I was often afraid for her life and adequacy, since she had already attempted suicide with the help of pills. In general, I took all the pills from her and began to give them the minimum. Then she took triftazine, amitriptyline and something else I don’t remember. For three years she was on a combination of 1 amitriptyline tablet + 1 aminazine at night. And it was wonderful. She sat, read newspapers, watched TV, and was quite adequate. But over the last six months something unimaginable has been happening. As usual, she became more aggressive and irritable. The psychiatrist (from my words, she had not seen my grandmother for about five years) decided to change the drug and prescribed chlorprothixene. She prescribed giving it in the afternoon: one after lunch, the other in the evening, at six o’clock. At first everything seemed to be relatively normal. But the first time the pills ran out on Sunday, their absence was immediately noticeable. Grandmother became aggressively capriciously irritable literally in one day. This alarmed me, but I once again bought chlorprothixene for 3 months. And then for another month. Now my grandmother refuses to get up, walks under herself when she eats, wets herself all over, screams and demands day and night - either pills, or how long it is, or to close the window - in general, she is completely fraying my nerves. To all my indignations she responds that she didn’t do it on purpose, accidentally, and in general, she doesn’t know who did it. Recently I went to the doctor again, ours wasn’t there, there was another one. I described the situation to her. She asked: “What should I prescribe?”!!! I could have asked for anything... I asked for sleeping pills. The doctor prescribed phenozepam. The last five days have turned into a nightmare. For the first two days, my grandmother was silent at night; I don’t know whether she was sleeping or not. I gave her one tablet of chlorprothixene at 12 and 18 o’clock, and one tablet of phenozepam at night. After taking a whole pill twice, I saw that her coordination was completely impaired, she couldn’t even sit, she was thrown around. The next two days I gave her half of phenazepam at night. The result is that my grandmother did not sleep, and again pulled me off at three to five in the morning. Yesterday I gave her a whole pill at night. She drank, but at three in the morning she began tossing and turning and muttering. At five she started screaming. When I arrived, I saw that the chewed tablet was lying on the floor in front of the bed. I gave her another one, hoping to sleep on her own... it turns out that at 6 am... At 11 am she screamed again. Did she spit it out again or am I missing something about the action of the pills? It couldn't have stopped in 5 hours? In general, now I want to remove chlorprothixene from her diet... it seems to me that her illness has only intensified with its use... In the days of amitriptyline and aminazine, everything was much more stable and harmonious.
Chlorprothixene and alcohol interaction. Chlorprothixene - instructions for use
Registration number:
Trade name of the drug
Chlorprothixene
International nonproprietary or generic name
Chlorprothixene
Dosage form:
Film-coated tablets.
Compound
One film-coated tablet, 15 mg, contains:
Active substance:
Chlorprothixene hydrochloride - 15,000 mg
Excipients:
Corn starch - 10,000 mg Lactose monohydrate - 92,000 mg Sucrose - 10,000 mg Calcium stearate -1,500 mg Talc - 1,500 mg
Film casing:
Opadry 32F250007 red – 5,000 mg
One film-coated tablet, 50 mg, contains:
Active substance:
Chlorprothixene hydrochloride - 50,000 mg
Excipients:
Corn starch - 37,500 mg Lactose monohydrate - 135,000 mg Sucrose - 20,000 mg Calcium stearate - 3,750 mg Talc - 3,750 mg
Film casing:
Description
15 mg tablets:
Biconvex, orange film-coated tablets.
50 mg tablets:
Biconvex film-coated tablets from light brown to light yellow.
Pharmacotherapeutic group
Antipsychotic (neuroleptic).
ATX code: N05AF03.
Pharmacological properties
Chlorprothixene is an antipsychotic drug derived from thioxanthene. It has antipsychotic, pronounced sedative and moderate antidepressant effects.
Pharmacodynamics
The antipsychotic effect of neuroleptics is associated with blockade of dopamine receptors, and also, possibly, blockade of 5-HT (5-hydroxytryptamine) receptors. In vivo, chlorprothixene has a high affinity for dopamine receptors type D1 and D2. Chlorprothixene also has high affinity for 5-HT2 receptors, α1-adrenergic receptors, histamine (H1) and cholinergic muscarinic receptors. The receptor binding profile of chlorprothixene is very similar to that of clozapine, but it has approximately 10 times higher affinity for dopamine receptors.
Chlorprothixene reduces the severity or eliminates anxiety, obsessions, psychomotor agitation, restlessness, insomnia, as well as hallucinations, delusions and other psychotic symptoms. The very low incidence of extrapyramidal effects (about 1%) and tardive dyskinesia (about 0.05%) indicate that chlorprothixene can be successfully used for maintenance treatment of patients with psychotic disorders.
Low doses of chlorprothixene have an antidepressant effect, which makes the drug useful for mental disorders characterized by anxiety, depression and restlessness. Also, during therapy with chlorprothixene, the severity of associated psychosomatic symptoms decreases. Chlorprothixene does not cause addiction, dependence or tolerance. In addition, chlorprothixene potentiates the effect of analgesics, has its own analgesic effect, as well as antipruritic and antiemetic effects.
