thiothixene / Generic mfg. - LARVOL DELTA

Exploring the Impact of Patient Characteristics and Reporting Period on Adverse Drug Withdrawal Event Signals in the FAERS Database: A Stratified Disproportionality Analysis Study (ISPOR-EU 2025) - "Tiotixene showed a stronger signal in the elderly (n=7; IC=3.81; PRR=208.14; ROR=353.13) versus adults (n=3; IC=2.23; PRR=12.44; ROR=13.32). This study suggests reporting signals for ADWEs due to some medications have varied over time, and may differ based on age and sex.FUNDING: Funded by the EU through the MSCA (Project acronym/number: HEAD-P/101149577)"

Adverse events • Clinical • ROR1

Considerations for Augmenting Aripiprazole Long-Acting Injectables with Other Antipsychotics: A Mini-Review. (PubMed, Diseases) - "Current literature on Ki values indicates that fluphenazine, pimozide, thiothixene, trifluoperazine, and perphenazine bind more strongly to dopamine D2 receptors than aripiprazole...Additionally, the muscarinic effects of aripiprazole suggest the possibility of augmentation with clozapine or xanomeline-trospium, albeit the peer-reviewed literature on this was also limited. Overall, it is difficult to draw conclusions regarding best clinical practices for these scenarios, as the existing literature is contradictory. Nonetheless, the application of the dopamine and muscarinic pathway theories for schizophrenia opens venues for future research and consideration."

Journal • Review • CNS Disorders • Psychiatry • Schizophrenia • DRD2

Sexual dysfunctions related to use of antipsychotics: A protocol for a systematic review and meta-analysis. (PubMed, PLoS One) - "The antipsychotic medications of interest are amisulpride, aripiprazole, asenapine, brexpiprazole, cariprazine, chlorpromazine, clopenthixol, clozapine, droperidol, flupenthixol, fluphenazine, haloperidol, iloperidone, levomepromazine, loxapine, lurasidone, molindone, olanzapine, paliperidone, penfluridol, perphenazine, perazine, pimozide, prochlorperazine, quetiapine, risperidone, sertindole, sulpiride, thiothixene, thioridazine, trifluoperazine, ziprasidone, zuclopenthixol and zotepine. The Cochrane Risk of Bias tool and RoB 2.0 will be used to assess the risk of bias in studies. We will evaluate the quality of the evidence contributing to network estimates for the primary outcomes using the GRADE framework, and key factors that may affect the observed effects will be analysed for consistency across studies."

Journal • Retrospective data • CNS Disorders • Sexual Disorders • PRL

Unsupervised Graph Clustering Reveals a Clinical Taxonomy of Antipsychotics (APA 2025) - "Cluster 1 contained Aripiprazole, Brexpiprazole, Cariprazine, Lurasidone, Sertindole, and Ziprasidone, and was characterized by an excellent side-effect profile but also with the lowest efficacy. Cluster 2 contained Chlorpromazine, Haloperidol, Loxapine, Molindone, Perphenazine, and Thiothixene, and showed strong efficacy in positive symptoms, but also had a high-risk for EPS, QTc prolongation and seizures. Cluster 3 contained Clozapine, Iloperidone, Olanzapine, Quetiapine, Thioridazine, and Zotepine, and showed strong overall efficacy but carried the highest risk for sedation and metabolic side effects. Cluster 4 contained Amisulpride, Asenapine, Paliperidone, Risperidone, and Sulpride, and showed excellent positive and negative symptom efficacy but carried the highest risk of hyperprolactinemia. Cluster 5 contained Flupentixol, Fluphenazine, Pimozide, and Trifluoperazine and showed the lowest efficacy with a high risk of causing EPS. Conclusion Despite traditional..."

Clinical • Anesthesia • CNS Disorders • Epilepsy • Hypotension • Psychiatry • Schizophrenia

The antipsychotic drug thiothixene stimulates macrophages to clear pathogenic cells by inducing arginase 1 and continual efferocytosis. (PubMed, Sci Signal) - "The prophagocytic effects of thiothixene in mouse macrophages depended on increased expression of the gene encoding the retinol-binding protein receptor Stra6L, which, in turn, promoted the production of the continual efferocytosis stimulator arginase 1. Our findings demonstrate that dopamine inhibits efferocytosis in macrophages and identify thiothixene, a generic, FDA-approved antipsychotic drug that has been in use for more than 50 years, as a promising candidate for promoting continual efferocytosis and the removal of diseased tissue."

Journal • Atherosclerosis • Cardiovascular • CNS Disorders • Infectious Disease • Oncology

Lurasidone versus typical antipsychotics for schizophrenia. (PubMed, Cochrane Database Syst Rev) - "We are very uncertain about whether lurasidone offers benefits to the mental state, total serious adverse events, or severe adverse events when compared to typical antipsychotics for people with schizophrenia. The evidence included in this review is of very low certainty, derived from two small trials. Study limitations (risk of bias) and imprecise results impacted our confidence in the evidence. Furthermore, data on mortality (due to suicide or natural causes) or quality of life are unavailable. Further large-scale randomized studies are needed to provide clearer insights into the benefits and harms of lurasidone compared to typical antipsychotics for treating schizophrenia."

Clinical • Journal • Review • CNS Disorders • Psychiatry • Schizophrenia

High throughput screen reveals that atypical antipsychotics promote continual efferocytosis by antagonizing dopamine signaling and promoting vitamin A-dependent Arginase1 upregulation (AHA 2024) - "Subsequent validation assays using Incucyte live-cell imaging assay in RAW cells, primary cultured murine macrophages, and human macrophages allowed us to identify the atypical antipsychotic drug, thiothixene, as a promising candidate for clinical translation, which induced cellular clearance without changing macrophage apoptosis, migration or proliferation... This unbiased screen identified unanticipated anti-efferocytic properties of dopamine, while highlighting the translational potential of a generic, FDA-approved anti-psychotic drug. This therapy may represent a novel method for promoting continual efferocytosis and the disposal of unwanted cells that otherwise can promote a range of clinical disorders including atherosclerosis."

Atherosclerosis • Cardiovascular • CNS Disorders • Dyslipidemia • Infectious Disease • Oncology • ARG1 • STRA6

Prediction of Antipsychotic-Induced Metabolic Adverse Effects Using Multimodal Artificial Intelligence (WCPG 2024) - ": In the CDW cohort, clinically significant weight gain (>7%) during antipsychotic use was related to Asian ethnicity, pre-treatment elevation in triglycerides, and use of thiothixene, systemic contraceptives, and antipsoriatics, but inversely related to antimigraine agents, opioid antagonist analgesics, and immune suppressants. In the MVP cohort, BMI increase was related to Hispanic ancestry, first-generation antipsychotics, older age, higher T2D PRS, and inversely related to BP PRS. : This is the largest study to date of genetic and environmental factors associated with antipsychotic-induced metabolic adverse effects."

Adverse events • Addiction (Opioid and Alcohol) • CNS Disorders • Diabetes • Dyslipidemia • Genetic Disorders • Immunology • Mental Retardation • Metabolic Disorders • Migraine • Obesity • Pain • Psychiatry • MVP

Deciphering Mechanisms of Psychiatric Drugs: Integrative Modeling of Gwas Signals and Gene Expression Profiles (WCPG 2024) - ": Notably, our integrative analysis identified known therapeutics such as Aripiprazole for schizophrenia and Trazodone for major depressive disorder among the top candidates. These drugs, along with others like Pimozide and Carbamazepine, demonstrated significant perturbation of susceptibility genes, enriching for biological functions and interacting with therapeutic drugs. Additionally, Thiothixene and Sertraline showed potential for schizophrenia and major depressive disorder, respectively, based on their adjusted p-values and rankings."

Gene expression profiling • CNS Disorders • Depression • Major Depressive Disorder • Mental Retardation • Mood Disorders • Psychiatry • Schizophrenia

Determining Ideal Management for Patients With Coexisting Prolactinomas and Psychiatric Symptoms: A Systematic Review. (PubMed, J Psychiatr Pract) - "Clinicians may find it beneficial to prioritize specific antipsychotics (aripiprazole, olanzapine, ziprasidone, or clozapine) over others (risperidone, thioridazine, thiothixene, and remoxipride). Discontinuing DA medication at least periodically until the patient's condition improves may also be advisable. If these 2 initial approaches do not yield a significant improvement in symptom management, surgery or radiation therapy may be considered. As patients may respond differently to these therapies, our study still recommends a patient-centered approach."

Journal • Review • CNS Disorders • Endocrine Cancer • Oncology • Pituitary Gland Carcinoma • Psychiatry

First-Generation Antipsychotic Shortages in the United States: Analysis of Switching and Utilization Patterns (ISPOR 2024) - "As a result of a shortage or discontinuation, all individuals (100%) treated with loxapine (n=1636), molindone (n=13), thioridazine (n=1587), and trifluoperazine (n=3939) switched to another antipsychotic...Among individuals initially receiving treatment with thiothixene (n=5752), 61.6% started a different antipsychotic within one year. Individuals utilizing pimozide (9.6%) and perphenazine (16.1%) had lower switch rates. Shortages acutely changed utilization patterns of first-generation antipsychotics, resulting in multiple individuals switching treatments immediately following the official declaration of a shortage or discontinuation."

CNS Disorders • Psychiatry • Schizophrenia

Withdrawal syndrome after antipsychotics discontinuation: an analysis of the WHO database of spontaneous reports (Vigibase) between 2000 and 2022. (PubMed, Psychopharmacology (Berl)) - "Our results suggest that there might be a risk difference for WDS between antipsychotics. Tiotixene, pimozide and quetiapine were associated with a higher risk of reporting a WDS whereas this risk was lower with chlorpromazine, clozapine and fluphenazine. We could not address the issue of withdrawal psychosis, withdrawal dyskinesia, rebound psychosis or supersensitivity psychosis due to the lack of specific WHO medDRA coded terms to identify potential cases."

Journal • CNS Disorders • Depression • Insomnia • Mood Disorders • Movement Disorders • Pain • Psychiatry • Sleep Disorder • DRD2

First generation antipsychotic-associated serious adverse events in women: a retrospective analysis of a pharmacovigilance database. (PubMed, Int J Clin Pharm) - "The subgroup analysis of haloperidol AEs revealed a significantly higher reporting odds ratio for TdP. Additionally, the secondary study findings suggest that women were more vulnerable to worse outcomes associated with certain AEs of FGAs."

Adverse events • Journal • Retrospective data • Serious adverse event • Agranulocytosis • CNS Disorders • Granulocytopenia • Movement Disorders

Do Antipsychotic Medications Causeprolactinoma Growth? A Systematic Review Of Imaging And Serum Findings (ENDO 2023) - "Preliminary results uncovered two major themes from our search: the use of certain antipsychotics (risperidone, haloperidol, thioridazine, thiothixene, and amisulpride) was associated with an increase in prolactin levels, and discontinuation led to a decrease in prolactin as well as normalization of the pituitary gland when imaging was provided...There were 2 patients taking risperidone without any worsening of their existing prolactinoma when taking the drug in small doses with cabergoline or when using a long acting form. In conclusion, while the relationship between antipsychotic use and prolactinoma growth may not be fully clear, it is known that ceasing medication use can help with treatment of the tumor. We recommend that providers be aware of the potential relationship between these drugs and this tumor and adjust treatment plans accordingly."

Late-breaking abstract • Review • CNS Disorders • Endocrine Cancer • Oncology • Pituitary Gland Carcinoma • Psychiatry • PRL

Umar Durrani (ENDO 2023) - "We found that four key themes emerged from the literature: 1) discontinuing risperidone in exchange for other atypical antipsychotics such as aripiprazole, olanzapine or ziprasidone, 2) discontinuing thioridazine, thiothixene and remoxipride in exchange for clozapine, 3) dopamine agonist therapy cessation to abate psychiatric symptoms, and 4) surgery and/or radiation after pharmacotherapy. Abstracts presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*"

CNS Disorders • Endocrine Cancer • Infertility • Mental Retardation • Oncology • Psychiatry • Schizophrenia • Sexual Disorders

Repeat Suicides in Two Schizoaffective Patients on Clozapine (APA 2023) - "Psychotropics included clozapine 350mg, cariprazine, risperidone, sertraline, and benztropine...Home psychotropics were clozapine 200mg, lithium, trazodone, topiramate, risperidone, thiothixene, and olanzapine... Clozapine remains the best option for treatment-resistant schizophrenia or high-risk suicidal ideations and behaviors. However, clozapine does not completely repress suicidality and may need augmentation. Though the data is convincing, there are multiple confounding factors, such as the impact of increased monitoring, hospitalizations, or study withdrawal if suicidal risk is significant."

Clinical • Bipolar Disorder • CNS Disorders • Psychiatry • Schizophrenia • Suicidal Ideation

Effects of antipsychotics on heart rate in treatment of schizophrenia: a systematic review and meta-analysis. (PubMed, Ther Adv Psychopharmacol) - "Some head-to-head comparisons were also significantly different: olanzapine versus haloperidol RR = 2.87, chlorpromazine versus thiothixene RR = 2.92, quetiapine versus lurasidone RR = 3.22, risperidone versus aripiprazole RR = 4.37, iloperidone versus ziprasidone RR = 4.65). Therefore, especially patients with cardiac risk factors should be monitored closely during antipsychotic treatment. PROSPERO: CRD42014014919."

Journal • Retrospective data • Review • Cardiovascular • CNS Disorders • Psychiatry • Schizophrenia

Antipsychotics for agitation and psychosis in people with Alzheimer's disease and vascular dementia. (PubMed, Cochrane Database Syst Rev) - "There is some evidence that typical antipsychotics might decrease agitation and psychosis slightly in patients with dementia. Atypical antipsychotics reduce agitation in dementia slightly, but their effect on psychosis in dementia is negligible. The apparent effectiveness of the drugs seen in daily practice may be explained by a favourable natural course of the symptoms, as observed in the placebo groups. Both drug classes increase the risk of somnolence and other adverse events. If antipsychotics are considered for sedation in patients with severe and dangerous symptoms, this should be discussed openly with the patient and legal representative."

Journal • Review • Alzheimer's Disease • Anesthesia • CNS Disorders • Cognitive Disorders • Dementia • Psychiatry

[VIRTUAL] Initiation on High Weight Gain Risk Versus Low Weight Gain Risk Antipsychotics: Do Baseline Characteristics Predict Prescribing Behavior? (APA 2021) - "Based on outpatient pharmacy claims, patients were categorized as initiating on high weight gain risk APs (olanzapine, chlorpromazine, iloperidone, paliperidone, quetiapine, risperidone, mesoridazine) or low/unknown weight gain risk APs (fluphenazine, haloperidol, perphenazine, thioridazine, thiothixene, aripiprazole, asenapine, lurasidone, ziprasidone, brexpiprazole, trifluoperazine, cariprazine). Cardiometabolic conditions that are associated with weight gain and obesity were not predictive of being prescribed a low weight gain risk AP, indicating the prescribing patterns may not take into account baseline characteristics when determining risk of AP side effect profiles. This study was funded by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA."

CNS Disorders • Depression • Diabetes • Dyslipidemia • Genetic Disorders • Hypertension • Metabolic Disorders • Obesity • Psychiatry • Schizophrenia • Type 2 Diabetes Mellitus

[VIRTUAL] The Point of Futility: A Unifying Concept to Define and Educate Clinicians about the Upper Limit of the Antipsychotic Plasma Level Range (ASCP 2021) - "2. To provide evidence based estimates of the point of futility for a range of antipsychotics where sufficient data exist to support an estimate: amisulpride, aripiprazole, chlorpromazine, clozapine, flupenthixol (cis isomer), fluphenazine, haloperidol, loxapine, olanzapine, paliperidone, perphenazine, risperidone (active moiety), thiothixene trifluoperazine, zuclopenthixol."

Clinical • CNS Disorders • Psychiatry • Schizophrenia

Lupus Cerebritis Refractory to Guideline-Directed Therapy: A Case Report. (PubMed, J Investig Med High Impact Case Rep) - "After exhausting the bank of anti-inflammatory and immunomodulators recommended by current guidelines, we found that a combination of rituximab infusions with thiothixene, an antipsychotic agent, significantly improved our patient's neuropsychiatric symptoms. Further research should be conducted to determine the efficacy of rituximab in the treatment of resistant lupus cerebritis, and to validate the use of thiothixene in the management of neuropsychiatric symptoms secondary to lupus."

Clinical • Journal • Bipolar Disorder • CNS Disorders • Immune Modulation • Immunology • Inflammation • Inflammatory Arthritis • Lupus • Mood Disorders • Psychiatry • Systemic Lupus Erythematosus

113 drug shortages in the US (Becker's ASC Review) - "As of Feb. 4, the FDA lists 113 drugs as being in short supply....Thiothixene capsules"

Commercial • CNS Disorders • Schizophrenia

Screening of FDA approved drugs for their ability to inhibit or worsen hydrogen peroxide mediated aggregation of calf lens crystallins (ARVO 2018) - "...Among those that worsened transparency are amiodarone, quinacrine and thiothixene...Surprisingly, hydrocortisone, a known risk factor for cataract, improved aggregation possibly by acting like a sterol or antioxidant...We have screened a small molecule compound library of FDA approved drugs for their ability to prevent or worsen oxidative damage to lens proteins. Candidate compounds discovered so far will be tested in an animal model for their ability to prevent or induce cataract, respectively."

Biosimilar • Ophthalmology

"Congratulations to #DrBoShen, @GKochharMD, #DrUdayNavaneethan, and entire Global Interventional IBD Group in publishing this landmark study #Crohns. Wonderful collaboration and #teamwork! @LancetGastroHep @AHNtoday @AdventHealthCFL @Highmark @ColumbiaMed @CrohnsColitisFn @IBDMD" (@ShyamTMD)

Clinical

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