levomepromazine / Generic mfg. - LARVOL DELTA

Therapeutic drug monitoring for antipsychotic medication to estimate drug adherence in Japanese patients with psychiatric disorders (CINP-AsCNP 2025) - " Patients who diagnosed with psychiatric disorders, including schizophrenia (SCZ), bipolar disorder, or major depressive disorder, at the Department of Psychiatry, Gifu University Hospital and prescribed antipsychotics (haloperidol, levomepromazine, aripiprazole, paliperidone, risperidone, olanzapine, and/or quetiapine) were enrolled between August 2021 and October 2023...Factor analysis was done by using factors possibly influencing adherence such as sex, age, diagnosis, number of drugs, antipsychotic dosage [calculated as chlorpromazine (CP) equivalents] and the use of concomitant drugs including antiparkinsonian drugs, antidepressants, benzodiazepines, and mood stabilizers... Consistent with previous reports, the better adherence rate determined by TDM for antipsychotics in Japanese patients was mostly same. Our results revealed that the concomitant medications contributed to improved adherence of antipsychotic medications with relatively high intensity treatment of..."

Adherence • Clinical • Drug adherence • Bipolar Disorder • CNS Disorders • Depression • Major Depressive Disorder • Mental Retardation • Mood Disorders • Movement Disorders • Parkinson's Disease • Psychiatry • Schizophrenia

"Is this sedation?" - a Group Delphi process to define cut-off doses and dosing intervals for potentially sedating drugs in palliative care. (PubMed, BMC Palliat Care) - "This study for the first time provides evidence- and expert consensus-based data to support clinical judgements regarding sedating effects of a range of potentially sedating drugs commonly used in palliative care."

Journal • Anesthesia • Palliative care

Determination of multiple psychostimulants and antipsychotics in postmortem dried blood spot samples by liquid chromatography-tandem mass spectrometry. (PubMed, Leg Med (Tokyo)) - "To test our novel analytical method we used liquid chromatography coupled with electrospray ionization-tandem mass spectrometry to quantify two psychostimulants (amphetamine, methamphetamine) and eight antipsychotics (chlorpromazine, haloperidol, levomepromazine, aripiprazole, clozapine, quetiapine, risperidone, and paliperidone) in cadaveric DBS samples. Comparison with our general practice method (known as QuEChERS) showed good positive correlations of the quantifiable concentrations of all drugs. In addition, for all drugs, the concentrations obtained by the DBS method were almost well coincident with those obtained by the QuEChERS method."

Journal • CNS Disorders

Austrian physicians’ knowledge of palliative care, assisted suicide, and palliative sedation: An exploratory study (OeGHO-AHOP 2025) - "Regarding PST, PC physicians more frequently adhered to guidelines and used midazolam (97.8% vs. 77.6%, p<0.001), propofol (56.2% vs. 38.1%, p=0.009), and levomepromazine (23.6% vs. 11.2%, p=0.016). Overall, Austrian physicians demonstrate insufficient knowledge of AS and PST, highlighting the need for increased education on the principles of palliative care to ensure informed practice after the legalization of AS. Nevertheless, PC physicians in Austria show superior adherence to guidelines in the management of life-limiting illnesses, PST and AS compared to non-PC physicians, highlighting the importance of specialized palliative care training."

Anesthesia • Cardiovascular • Chronic Obstructive Pulmonary Disease • Congestive Heart Failure • Heart Failure • Hepatology • Immunology • Palliative care • Respiratory Diseases

Frequency and predictors of palliative sedation among patients with cancer who died in a specialist inpatient palliative care unit: a retrospective study. (PubMed, BMC Palliat Care) - "A total of 38% of patients with cancer receiving specialized palliative care required PS before death. Patients who received PS were younger, had a longer hospital stay, were more likely to have their spouse be their primary caregiver, were better informed and had more advance directives. 28% of sedated patients required more than one drug, which was associated with a longer PS, the maintenance of parental hydration during PS and the initiation of PS with levomepromazine instead of midazolam."

Journal • Retrospective data • Anesthesia • CNS Disorders • Mood Disorders • Oncology • Palliative care • Psychiatry

Phenobarbital for inpatient palliative sedation-a clinical audit. (PubMed, BMJ Support Palliat Care) - "Phenobarbital appears to be an effective medication for PST. However, inconsistencies in dosing, concurrent sedative medication use and standardised protocols highlight areas for improvement in clinical guidelines."

Journal • Anesthesia • CNS Disorders • Palliative care

Evaluating physicians' knowledge of assisted suicide and palliative sedation therapy in Austria : An exploratory survey study. (PubMed, Wien Klin Wochenschr) - "Overall, Austrian physicians demonstrate insufficient knowledge of AS and PST, underlining the need for enhanced education on PC principles to ensure informed practice post-AS legalization. Nonetheless, PC physicians in Austria demonstrate superior adherence to guidelines in managing life-limiting conditions, PST and AS compared to non-PC physicians, highlighting the importance of specialized PC education."

Journal • Anesthesia • Palliative care

Response to amoxicillin and perampanel in infantile Alexander disease. (PubMed, Epilepsia Open) - "Although there is no treatment, mild symptomatic improvement has been reported in one case of adult Alexander treated with ceftriaxone, given its interaction with the mutant glial fibrillary acid protein (GFAP) responsible for the disease's pathogenesis...Since irritability had worsened and had not responded to levomepromazine, treatment with amoxicillin (80 mg/kg/day) was attempted to modulate glutamate levels...The patient had frequent daily seizures which did not respond to valproate, clonazepam, or phenobarbital...However, doctors believe that drugs like amoxicillin and perampanel could be promising treatments for managing symptoms of Alexander disease and other similar brain conditions in the future, especially where excess glutamate plays a role in the damage. This case suggests that these treatments may help control irritability and seizures, offering hope for better management of this challenging disease."

Journal • CNS Disorders • Epilepsy • Gastroenterology • Gastroesophageal Reflux Disease • Rare Diseases • Vascular Neurology • Ventriculomegaly • GFAP

THE HISTORY OF MEDICAL CARE OF PATIENTS WITH MENTAL ILLNESS BY EXAMPLE OF THE OLDEST PSYCHIATRIC HOSPITAL IN POLAND (WPA 2024) - "The first psychiatric drugs administered to treat were: morphine (till 1914), bromine salts(1857), chloral hydrate(1869) and scopolamine(1880)...The first neuroleptic drugs - chlorpromazine and reserpine – have been used since 1956...New antidepressant drugs were first administered in 1992 and new antipsychotic drugs (clopenthixol, stelazine, sulpiride, levomepromazine) were in use from 1991.ConclusionsRegional Psychiatric Hospital for Neurologically and Mentally Ill Patients celebrates its 169th founding anniversary this year. Each year thousands of patients are being treated there according to the latest psychiatric recommendations."

Clinical • Alzheimer's Disease • CNS Disorders • Dementia • Depression • Psychiatry • Schizophrenia

An extended substrate spectrum of the proton organic cation antiporter and relation to other cation transporters. (PubMed, Basic Clin Pharmacol Toxicol) - "They included antidepressants (like tranylcypromine or nortriptyline), antipsychotics (like levomepromazine) and local anaesthetics. The substrate overlap between the H+/OC antiporter and OCTN1, OCTN2 or OCT3 was minimal, indicating that the latter three are not the proteins underlying the H+/OC antiporter activity. Overall, about 50% of positively charged drugs may be substrates of the antiporter, which may be the most important membrane transport protein for many drugs."

Journal • Anesthesia • CNS Disorders

JUST IN CASE BOXES ARE CENTRAL TO THE PROVISION OF END OF LIFE CARE TO CHILDREN AND YOUNG PEOPLE WITH CANCER (SIOP 2024) - "Drugs included oral/IV morphine sulphate, buccal/iv benzodiazepine, levomepromazine, cyclizine, dexamethasone and transdermal hyoscine. JIC Box are vital to deliver rapid, symptom relief to paediatric Haemato-Oncology patients receiving community end of life care. JIC box guidelines and template prescriptions became nationally available for Haemato-Oncology patients. This model was duplicated in the non malignant population, providing standardised, safe care at the end of life, irrespective of diagnosis."

Clinical • Oncology • Pediatrics

Concurrent management of treatment-resistant depression, insomnia, and hydrocephalus: a case study emphasizing the need for comprehensive care (ECNP 2024) - "Finally, a shunt was implanted to drain the excess fluid into the renal system.For his psychiatric symptoms, he was prescribed Escitalopram (10mg daily) and Levomepromazine (25mg daily)...However, five years later, the patient's insomnia returned, along with benzodiazepine abuse, as he was receiving Alprazolam and Clonazepam from another medical service...Additionally, the patient developed cerebral atrophy which led to mixed dementia. This combination of physical and mental health challenges underscores the intricate nature of treating hydrocephalus and the necessity of a comprehensive, multidisciplinary approach."

Case study • Clinical • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Dementia • Depression • Insomnia • Mental Retardation • Psychiatry • Restless Legs Syndrome • Sleep Disorder • Vascular Neurology • Ventriculomegaly

Not everything is what it seems: Wernicke encephalopathy vs chronic adult hydrocephalus (ECNP 2024) - "As there was difficulty in controlling the agitation with oral medication, he eventually required mechanical restraint in 5 points for Intramuscular medication administration (Haloperidol + Levomepromazine). It is a medical emergency, and treatment with intravenous Thiamine therapy should be initiated when suspected [2].While no studies are confirming a direct association between Wernicke's encephalopathy and chronic adult hydrocephalus, cases of acute hydrocephalus following severe encephalopathy syndromes, including Wernicke's encephalopathy, have been documented [2].In Conclusion , the presented case illustrates the complexity and importance of considering multiple differential diagnoses in patients with a history of alcohol abuse and acute neurological symptoms. Through this case, we highlight the need to conduct a comprehensive evaluation and maintain an open-minded approach to less common diagnoses, especially in patients with risk factors such as alcohol..."

Clinical • Addiction (Opioid and Alcohol) • Ataxia • CNS Disorders • Psychiatry • Psychomotor Agitation • Ventriculomegaly

Psychopharmacological treatment of children with autism spectrum disorder: experiences of the reference center (ECNP 2024) - "Second-generation antipsychotics were the predominant choice, with risperidone being the most frequently prescribed, and right after aripiprazole. In cases where treatment with second-generation antipsychotics was unsuccessful, 17.39% of patients were prescribed first-generation antipsychotics (Haloperdiole, Chlorpromazine, Levomepromazine)...Antidepressants and methylphenidate were less commonly prescribed, with only 5% of patients receiving them... This data highlights that psychotropic medications prescribed to ASD children are heterogeneous and often based on clinicians' experience. Although scientific reports discuss common psychiatric comorbidities occurring in children with ASD, beyond just irritability and aggression, the Results of this study from a reference center on the use of psychotropic medications in ASD children, have limited support to this. Few psychopharmacological therapies, aside from antipsychotics, are utilized."

Clinical • CNS Disorders • Mental Retardation • Psychiatry

Levomepromazine for chronic pain: recovering old drugs for current challenges (ECNP 2024) - "In the 60s and 70s, levomepromazine was studied and compared with morphine in the management of different painful conditions with positive Results . Levomepromazine is unique in that there is evidence for reliable dose-related analgesia that is comparable to opioid-mediated analgesia. The drug has a place in the relief of pain in a wide variety of painful conditions. Its role as a monotherapy treatment or as and add-on theraphy in painful conditions should be better stablished."

Addiction (Opioid and Alcohol) • CNS Disorders • Depression • Musculoskeletal Pain • Neuralgia • Pain • Psychiatry • Substance Abuse

Challenging pharmacotherapy management of a psychotic disorder due to a delicate pharmacogenetic profile and drug-drug interactions: a case report and literature review. (PubMed, Croat Med J) - "In spite of adherence to aripiprazole, olanzapine, risperidone, and levomepromazine, and rational anxiolytic therapy, she still experienced anxiety, anhedonia, loss of appetite, sleeping problems, and auditory hallucinations with commands to harm herself...Carbamazepine was discontinued, aripiprazole was increased to a maximum of 30 mg/day orally with long-acting injection (400 mg monthly), and olanzapine was increased to a daily dose of 35 mg orally...At the last follow-up, the patient was without severe auditory hallucinations, became more engaged in daily life, had more interaction with others, had found a job, and even had started an emotional relationship. In psychiatry, pharmacogenetic testing is an important tool for guiding pharmacological therapy, particularly in patients with an unsatisfactory clinical response and a lack of alternative therapeutic steps for pharmacotherapy unresponsiveness."

Biomarker • Journal • Review • Anorexia • CNS Disorders • Mood Disorders • Psychiatry • Schizophrenia • Sleep Disorder • ABCB1 • COMT • CYP1A2 • CYP3A4 • CYP3A5 • UGT1A4

Comparative in vitro hepatic clearances of commonly used antidepressants, antipsychotics, and anti-inflammatory agents in rainbow trout liver S9 fractions. (PubMed, Aquat Toxicol) - "The test substances included four anti-inflammatory agents (diclofenac, ibuprofen, ketoprofen, naproxen), seven antidepressants/antipsychotics (citalopram, haloperidol, levomepromazine, mirtazapine, risperidone, sertraline, venlafaxine) and the O-desmethyl metabolite of venlafaxine. Finally, we carried out intrinsic clearance assays with mixtures of diclofenac, ibuprofen, naproxen, levomepromazine, and sertraline to examine the impacts of EROD and BFCOD inhibitions on their in vitro CLINT in RT-S9. Our in vitro data suggests that the intrinsic clearances of ibuprofen, levomepromazine, and sertraline in rainbow trout can be significantly reduced as the result of P450 inhibition by pharmaceutical mixtures, whereas the clearances of diclofenac and naproxen are less impacted."

Journal • Preclinical • CNS Disorders

NHS-Reimbursed Cannabis Flowers for Cancer Palliative Care and the Management of Chemotherapy-Induced Nausea and Vomiting: An Autobiographical Case Report. (PubMed, Cureus) - "He received FOLFIRI (folinic acid, fluorouracil, and irinotecan) chemotherapy and underwent an emergency Hartmann's procedure with subsequent second-line FOLFOX (folinic acid, fluorouracil, and oxaliplatin) chemotherapy and lung ablation...Antiemetics metoclopramide and aprepitant demonstrated moderated efficacy. Antiemetics ondansetron, levomepromazine, and nabilone were associated with intolerable side effects. Inhalation of THC-predominant cannabis flowers in association with standard medication improved CINV, anxiety, sleep quality, appetite, overall mood, and quality of life. Our results add to the available evidence suggesting that medicinal cannabis flowers may offer valuable support in cancer palliative care integrated with standard-of-care oncology treatment. The successful individual funding request in this case demonstrates a pathway for other patients to gain access to these treatments, advocating for broader awareness and integration..."

CINV • Journal • Chemotherapy-Induced Nausea and Vomiting • Mood Disorders • Non Small Cell Lung Cancer • Oncology • Palliative care • Psychiatry

An autopsy case of intoxication caused by drug interaction with multiple psychotropic drugs, fluvoxamine, levomepromazine, and trihexyphenidyl. (PubMed, Leg Med (Tokyo)) - "Toxicological analysis using liquid chromatography tandem mass spectrometry (LC-MS/MS) identified a toxic level of fluvoxamine (0.947 µg/mL), and concentrations greater than the therapeutic levels of levomepromazine (0.238 µg/mL) and trihexyphenidyl (0.225 µg/mL) were present, while bromazepam, haloperidol, sulpiride, and 7-aminoflunitrazepam were within or below their therapeutic ranges. In addition, combined use of trihexyphenidyl may potentiate anticholinergic effects of fluvoxamine overdose, including convulsions and coma. It was concluded that the cause of the subject's death was the interaction of multiple drugs."

Journal • CNS Disorders • Epilepsy

Report on palliative sedation medication usage: a survey of palliative care experts in Eight European countries. (PubMed, BMC Palliat Care) - "Our study provides insight about the differences in the perceived practice of medication during palliative sedation between eight European countries. In countries where palliative care services have been established longer perceptions regarding medication use during palliative sedation were more in line with the recommended European guidelines than in Central and Eastern European countries like Romania and Hungary."

Journal • Anesthesia • Palliative care

Cytotoxicity of Pharmaceuticals and Their Mixtures Toward Scaffold-Free 3D Spheroid Cultures of Rainbow trout (Oncorhynchus mykiss) Hepatocytes. (PubMed, Eur J Pharm Sci) - "Among the test substances, the azole antifungals (clotrimazole and ketoconazole) were identified as the most cytotoxic, with hepatic metabolism indicatively amplifying their toxicity, followed by fluoxetine, levomepromazine, and sertraline, which were slightly less toxic toward the metabolically active primary cells than RTH-149 spheroids. As a result, the classical concentration addition approach was concluded sufficiently accurate for preliminarily informing on the approximate effect concentrations of pharmaceutical mixtures on a cellular level. However, direct read-across from human data was proven challenging and inexplicit for prediction of hepatotoxicity in fish in vitro."

Journal • Hepatology

EVALUATING AN UPDATED ANTIEMETIC PROTOCOL IN HAEMATOPOIETIC STEM CELL TRANSPLANTATION (MASCC-AFSOS-ISOO 2024) - "In the group that progressed to a combination of ondansetron and levomepromazine, 3 (43%) reported good control, and 4 (57%) had poor control. Conclusions The majority of patients in this cohort required combinations of antiemetics beyond ondansetron alone. The early results of this study do not support the use of olanzapine monotherapy in preference to combination therapy in this population."

Clinical • Bone Marrow Transplantation • Transplantation

Novel, fast, and reliable electrochemical dsDNA biosensor based on O-terminated pristine nanocrystalline boron-doped diamond electrode for DNA interaction studies. (PubMed, Bioelectrochemistry) - "The bioanalytical applicability of the fabricated dsDNA/O-B-NCDE biosensor was verified by examining the nature of the interaction between dsDNA and five selected DNA intercalators - namely thioridazine hydrochloride (TR), trimipramine maleate (TRIM), levomepromazine maleate (LEV), imipramine hydrochloride (IMI), and prochlorperazine maleate (PER) - where intercalation was proven for all of the five tested compounds. Moreover, the proposed novel bioanalytical test offers the possibility to selectively distinguish between the phenothiazine representatives (TR, LEV, and PER) and representatives of tricyclic antidepressants group (TRIM and IMI)."

Journal

EVALUATING AN UPDATED ANTIEMETIC PROTOCOL IN HAEMATOPOIETIC STEM CELL TRANSPLANTATION (EBMT 2024) - "In the group that progressed to a combination of ondansetron and levomepromazine, 3 (43%) reported good control, and 4 (57%) had poor control. The majority of patients in this cohort required combinations of antiemetics beyond ondansetron alone. The early results of this study do not support the use of olanzapine monotherapy in preference to combination therapy in this population."

Clinical • Bone Marrow Transplantation • Transplantation

Comparison of pharmacological treatments for agitated delirium in the last days of life. (PubMed, J Pain Symptom Manage) - "Haloperidol with as-needed benzodiazepine, chlorpromazine, or levomepromazine may be effective and safe for terminal agitation. Chlorpromazine and levomepromazine may have an advantage of no need to change medications."

Journal • Anesthesia • CNS Disorders • Oncology • Palliative care