Clopixol (zuclopenthixol) / Lundbeck - LARVOL DELTA

Long-term effectiveness, adherence and safety of twice-yearly paliperidone-palmitate long acting-injectable in patients with schizophrenia in Europe: 2-year mirror-image data from the paliperdone-2 per year study (P2Y). (PubMed, Front Psychiatry) - "The majority of patients had switched to PP6M from either PP3M (76%) or PP1M (19%) while the 3% switched from aripiprazole 1-monthly and the 2% from risperidone-LAI and zuclopenthixol-LAI. Nonetheless, we were unable to determine the precise changes in symptoms. Therefore, future studies are needed to truly establish the role of PP6M."

Journal • CNS Disorders • Psychiatry • Schizophrenia

The Effect of Age on Antipsychotic Serum Concentration in Males and Females: A Study Based on Therapeutic Drug Monitoring Data From 19,926 Patients. (PubMed, Ther Drug Monit) - "The age-dependent increase in dose-adjusted serum concentrations among males and females varied across different antipsychotics and was highest for risperidone. These findings emphasize the importance of proper monitoring of antipsychotic use in older adults."

Journal • CNS Disorders

Addition of long-acting injectable antipsychotics during manic episodes in bipolar disorder: A retrospective analysis of rehospitalizations. (PubMed, J Affect Disord) - "Our findings suggest that the addition of LAIs for bipolar mania during acute inpatient treatment is associated with reduced rehospitalizations, particularly among patients with recurrent hospitalizations, making it a valuable option. However, the lack of outpatient prescription data limits our ability to further substantiate this concept, warranting future research."

Journal • Retrospective data • Bipolar Disorder • CNS Disorders • Mood Disorders • Psychiatry

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

Zuclopenthixol reduces activity-dependent glioblastoma proliferation (SNO 2024) - "We show that zuclopenthixol treatment significantly reduced the proliferation index. Our experimental model allowed the optimization of organotypic human cortical slice cultures for immunofluorescence studies and live-cell imaging."

Brain Cancer • CNS Disorders • CNS Tumor • Glioblastoma • Oncology • Solid Tumor

Psychotic episode with paranoid delusions following reboxetine use: a case report (ECNP 2024) - "He was diagnosed with panic disorder and treated with paroxetine 30 mg/day and sertraline 50 mg/day at different times until one year ago when his treatment was changed to reboxetine 4 mg/day and risperidone 1 mg/day due to sedation side effects. His treatment was adjusted to reboxetine 8 mg/day and trifluoperazine 1 mg/day due to no improvement in symptoms and increased sleep duration...He received a single intramuscular injection of zuclopenthixol acuphase 50 mg during admission. Treatment was initiated with intramuscular haloperidol 10 mg twice daily and biperiden 5 mg twice daily...Discharged on the 14th day of hospitalization with olanzapine at 10 mg/day. The literature on the association between antidepressants and psychosis is growing...Further research is warranted on the effects of SNRIs like reboxetine on psychotic symptoms. Therefore, careful use of antidepressants and monitoring of symptoms are necessary."

Case report • Clinical • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Narcolepsy • Parkinson's Disease • Psychiatry • Sleep Disorder

The use of zuclopenthixol depot in an adolescent with methamphetamine induced schizophrenia (ECNP 2024) - "The patient was diagnosed with methamphetamine induced schizophrenia and oral risperidone 2 mg per day and quetiapine 25 mg per day (to regulate sleep) were started... Although not first line, typical antipsychotics are beneficial for some selected patients especially when diagnosed with severe mental disorders. The abuse of narcotic drugs and psychotropic substances such as amphetamines has shown a growing trend since 2000s and stated to become a public health problem. In this report, we presented the use of zuclopenthixol LAI in a methamphetamine induced schizophrenia case."

ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Cognitive Disorders • Mental Retardation • Mood Disorders • Psychiatry • Schizophrenia • Substance Abuse

Lifesaving medicine or a gateway to debauchery – a case report (ECNP 2024) - "A part of these drugs can include dextromethorphan which can be used via serotoninergic mechanism to delay orgasms, pseudoephedrine, an alpha1-adrenergic receptors agonist for the stimulant effects and codeine, which is metabolized by 2D6 to morphine [3].CASE REPORT: We present the case of a 36-year-old man with schizophrenia since 2008 and a long history of drug abuse. Since 2004 he used drugs such as cannabis, amphetamines, benzodiazepines, lysergic acid diethylamide, fentanyl and phencyclidine, and he has multiple hospitalizations in the last 7 years in the context of overdose with different drugs also used in the medical system. Multiple episodes of drug overdose involved around 10 tablets of trihexyphenidyl (2 mg each), gabapentin (300 mg each), olanzapine (10 mg each), carbamazepine (200 mg each) and other drugs such as benzydamine, codeine, pseudoephedrine and dextromethorphan...The patient takes treatment with injectable zuclopenthixol every two weeks and 10..."

Case report • Clinical • Addiction (Opioid and Alcohol) • CNS Disorders • Mental Retardation • Psychiatry • Schizophrenia • Suicidal Ideation • ADRA1B

A case report: Treatment with clozapine in treatment-resistant schizophrenia (ECNP 2024) - "Psychiatrically, he was diagnosed with paranoid schizophrenia with a history of irregular treatments and resistance to different antipsychotics: aripiprazole (oral and IM), olanzapine, quetiapine, paliperidone (oral and IM), lurasidone, and zuclopenthixol (oral and IM). Work was done with the patient from a psychoeducational perspective, as well as disease awareness, early detection of relapse symptoms, and commitment to treatment.After a month and a half of hospitalization, discharge was processed with clozapine treatment at 350mg/day. He returned to work normally and attended follow-up appointments at the Mental Health Center, remaining stable with correct medication adherence."

Case report • Clinical • CNS Disorders • Mental Retardation • Parkinson's Disease • Psychiatry • Schizophrenia

Pharmacological interventions in severe refractory tourette syndrome (ECNP 2024) - "Due to the severity of Tourette syndrome and its resistance to various pharmacological treatments, this case is one that we follow closely in the clinic and evaluate together with our professors in meetings._The patient's social skills deteriorated within two years following the onset of his mildly severe tics at the age of 13, and for the past year, he has been unable to attend school.Since clonidine was hard to come by and guanfacine was unavailable in our nation when we started our treatment follow-up, we were prescribed risperidone, ariprazole, haloperidol, clonidine, clopixol, aripiprazole, and pimozide, olanzapine in that order.Antipsychotic use was restricted for a prolonged period of time due to the patient's development of joint stiffness, as they are susceptible to the extrapyramidal adverse effects of these drugs. Tics worsened throughout clonidine treatment at the effective dose and duration, and the hypotensive impact of clonidine made it harder for..."

ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Depression • Mood Disorders • Psychiatry • Tic Disorders • Tourette Syndrome

Use of first-generation antipsychotics in the treatment of psychomotoragitation: a retrospective observational study of efficacy and tolerability (ECNP 2024) - "FGAs block D2 and also have antihistamine, anti alpha-adrenergic and anticholinergic effects, which may be a valid option due to their quicly sedative effects.Objective:The purpose of this study is to evaluate the efficacy and tolerability of five FGAs (haloperidol, chlorpromazine, clotiapine, promazine, and zuclopenthixol) used in the treatment of psychomotor agitation, while also examining the correlation between the drug given and the patient's age. Older patients were most often treated with promazine, while younger patients were more often treated with clotiapine. A goal for future studies may be to analyze more variables to obtain a personalized treatment of psychomotor agitation."

Observational data • Retrospective data • Bipolar Disorder • CNS Disorders • Psychiatry • Psychomotor Agitation • Schizophrenia

Using in silico methods to determine optimal tapering regimens for decanoate-based long-acting injectable psychosis drugs. (PubMed, Ther Adv Psychopharmacol) - "We aimed to apply hyperbolic principles of tapering to the decanoate-based LIDAs flupentixol, zuclopenthixol and haloperidol to develop withdrawal regimens. Reduction to the point of full discontinuation can only be achieved by switching to oral therapy to complete the taper. These results are limited by the in silico and theoretical nature of the study, and there is a need to confirm these findings through real-world observational and interventional studies."

Journal • CNS Disorders • Psychiatry

Genetic diversity of cytochrome P450 in patients receiving psychiatric care in Greece: a step towards clinical implementation. (PubMed, Pharmacogenomics) - "Dosage adjustment need was estimated for 10.2% of venlafaxine, 10.0% of paroxetine, 6.4% of sertraline, 30.8% of citalopram, 52.1% of escitalopram, 18.2% of fluvoxamine, 54.1% of tricyclic antidepressants, 16.7% of zuclopenthixol, 10.6% of haloperidol and 13.3% of risperidone treated patients. Clinical psychiatric pharmacogenomic implementation holds promise to improve drug effectiveness and safety."

Journal • CNS Disorders • Psychiatry • CYP1A2 • CYP2C19 • CYP2C9 • CYP3A5

The Examination of Black Hairy Tongue Disease through a Case in Psychiatric Patients (WFSBP 2024) - "He received treatment with Zuclopenthixol injection, Olanzapine 5mg, Aripiprazole 5mg, and Biperiden...From the patient's history, it was determined that he was initially admitted to our clinic in 2020 with a diagnosis of schizoaffective disorder (SAD)- manic episode, and he was managed with Haloperidol depot injection and Olanzapine 20mg...In 2021, the patient was admitted to our clinic with a diagnosis of SAD- depressive episode, and his treatment was arranged as Aripiprazole 400mg injection, Quetiapine 100mg, and Sertraline 100mg... In our case, poor oral hygiene, smoking, and the use of Olanzapine, which can cause dry mouth, are present. The presence of black hairy tongue (BHT) in our patient during periods of Olanzapine use, the absence of this condition when using non-Olanzapine medications, and the rapid regression of the lesion after discontinuing Olanzapine suggest that Olanzapine is significant in terms of the etiology of BHT in our patient, in addition to..."

Clinical • Bipolar Disorder • CNS Disorders • Depression • Mental Retardation • Psychiatry • Schizophrenia

Antipsychotic Zuclopenthixol Inhibits Melanoma Growth and Brain Metastasis by Inducing Apoptosis and Cell Cycle Arrest. (PubMed, Front Biosci (Landmark Ed)) - "These results demonstrate that zuclopenthixol has significant potential as an effective therapeutic agent for MBM."

Journal • CNS Disorders • Melanoma • Oncology • Solid Tumor

Illness-related outcomes of illicit substance use disorder in adolescents with early onset schizophrenia: a multicenter study. (PubMed, J Addict Dis) - "The EOS + SUD group exhibited a higher illness onset, fewer years of education, longer duration of untreated psychosis (DUP), a higher frequency of male gender, more frequent hospitalizations, increased use of clozapine and zuclopenthixol LAI, along with higher rates of post-traumatic stress disorder and conduct disorder. Our findings support the notion of SUD playing a role in modifying the course of illness in EOS. Future studies should emphasize exploring treatment responses to medications and interventions among youth with dual diagnoses."

Clinical • Journal • Behavior Disorders • CNS Disorders • Mood Disorders • Post-traumatic Stress Disorder • Psychiatry • Schizophrenia

Successful Clozapine Rechallenge After Clozapine-Induced Severe Anemia: A Case Report. (PubMed, Schizophr Bull) - "PRCA is a very rare adverse effect of clozapine. The cause of drug-induced PRCA is still unknown; for clozapine, there are no studies. Rechallenge after a severe and rare adverse effect is a complex decision. This case is the first to report a successful clozapine rechallenge following severe anemia without other blood dyscrasias, emphasizing the imperative need for close monitoring during the rechallenge process. Further study is warranted to understand the predictive factors for a successful outcome in clozapine rechallenges."

Journal • Agranulocytosis • Anemia • CNS Disorders • Granulocytopenia • Hematological Disorders • Neutropenia • Psychiatry • Schizophrenia

Proportion of Antipsychotics with CYP2D6 Pharmacogenetic (PGx) Associations Prescribed in an Early Intervention in Psychosis (EIP) Cohort: A Cross-Sectional Study. (PubMed, J Psychopharmacol) - "Two-thirds (164) of patients had been prescribed a 'CYP2D6-PGx antipsychotic' (aripiprazole, risperidone, haloperidol or zuclopenthixol). There were no statistically significant differences between age, sex, or ethnicity in the likelihood of being prescribed a 'CYP2D6-PGx antipsychotic'. This study demonstrated high rates of prescribing 'CYP2D6-PGx-antipsychotics' in an EIP cohort, providing a rationale for further exploration of how PGx testing can be implemented in EIP services to personalise the prescribing of drugs for psychosis."

Biomarker • Journal • Observational data • CNS Disorders • Psychiatry • Schizophrenia • CYP2D6

30-Year Follow-Up of the Cantabria First-Episode-Schizophrenia Study, From Early Intervention to Chronicity (SIRS 2024) - "Among those treated with antipsychotics (n=51), 19.6% received long-acting injectable: 6 paliperidone palmitate, 1 aripirpazole maintenta, 1 risperidone, and 2 zuclopenthixol decanoate. The most frequently prescribed oral antipsychotic was olanzapine (n=15, 29.4%), with a mean dose of 13.5mg. 9 patients were on clozapine (17.6%, mean dose 334.4mg), 4 aripiprazole (mean dose 2024 Congress of the Schizophrenia International Research Society 13.75mg), 4 risperidone (mean dose 3.5mg), 3 paliperidone (mean dose 6mg), and 5 perphenazine (mean dose 7.2 mg). Mean chlorpromazine equivalent dose for all the patients on antipsychotics was 546.7 (median 450.0)... At the time of the medical records review, at 30-years follow-up, 56 patients (63.6%) had a diagnosis of non-affective psychosis, mainly schizophrenia (n=46, 52.3%), while 10.2% (n=9) had a diagnosis of bipolar disorder. While 67% (n=59) had a recognized disability, 20 were currently working and 5 were retired. Only 42..."

CNS Disorders • Schizophrenia

Case Report of Treatment of Neuroleptic Malignant Syndrome in Child and Adolescent (SIRS 2024) - "Even though akathisia subsided slightly, risperidone was combined alternatively with aripiprazole, ziprasidone, and quetiapine due to residual symptoms...After treatment with 6mg of risperidone in combination with 300 mg of quetiapine, 80 mg of propranolol for prevention of akathisia, and 1.5 mg of benzodiazepine, psychotic symptoms and difficulties in communication improved enough to be discharged...Quetapine was increased to 600 mg, and symptoms, when severe, were controlled with IM injection of 2.5 mg of haloperidol and 2 mg of lorazepam Since March 25th of 2021, due to manifestation of paralytic ileus from worsening of underlying constipation, all the oral medications were stopped along with NPO for treatment; in addition, IM 2024 Congress of the Schizophrenia International Research Society injection of haloperidol was only allowed for the symptom control...Diazepam (IV), dantrolene, domperidone, L-Dopa/benserazideand and cold blanket were applied because the patient..."

Clinical • CNS Disorders • Schizophrenia

Living Systematic Review and Meta-Analysis of Pharmacokinetic Drug-Gene Interactions in Schizophrenia Pharmacotherapy: The Importance of CYP450 Genetic Polymorphism (SIRS 2024) - "This will include interactions of: Aripiprazole with CYP3A4/5; Asenapine with CYP1A2 and UGT1A4; Clozapine with CYP2D6, CYP1A2 and CYP3A4/5; Iloperidone with CYP3A4/5 and CYP2D6; Olanzapine with UGT1A4 and CYP1A2; Quetiapine with CYP3A4/5; Risperidone with CYP3A4/5; Zotepine with CYP3A4/5 and CYP1A2; Haloperidol with CYP3A4/5, UGT2B7 and CYP1A2; Chlorpromazine with CYP1A2, CYP3A4 or CYP2D6; and Zuclopenthixol with CYP3A4/5 and CYP2D6. As this abstract describes the proposed protocol for the living systematic review and meta-analysis, no results are available at the time. This living systematic review and meta-analysis will aim to encompass all clinically relevant antipsychotic drugs that are metabolized by at least one liver enzyme that is coded by the polymorphic gene. This way, the comprehensive database of pharmacokinetic drug-gene interactions relevant for the schizophrenia therapy will be created."

PK/PD data • Retrospective data • Review • CNS Disorders • Schizophrenia • CYP1A2 • CYP2C19 • CYP2D6 • CYP3A4

IMPORTANCE OF THE TYPE OF PHARMACOLOGICAL TREATMENT IN PATIENTS WITH SEVERE MENTAL DISORDER (EPA 2024) - " We select patients with different severe mental disorders who stay in a Medium Stay Unit, Sociosanitary Community Residence, Supervise house and Residence for the elderly in Albacete (Spain); all of them, with intramuscular neuroleptic treatment (zuclopenthixol dihydrochloride, aripiprazole long acting, palmitate paliperidone monthly, 3-monthly and 6-monthly) at least 1 year...31% of the patients with zuclopenthixol dihydrochloride treatment, have gone to psychiatric emergencies and 28% of psychiatric admissions in the last year.18% of the patients with aripiprazole long acting, 17% with paliperidone palmitate long acting-monthly and 12% de 3-monthly have gone to psychiatric emergencies and 15%, 12% and 12% needed psychiatric admissions respectively. - The longer long acting of the intramuscular treatments, the better patient satisfaction.- With the longer duration treatment (Palmitate paliperidone LD 6 month), we have lower psychiatric emergencies and hospital..."

Clinical • Bipolar Disorder • CNS Disorders • Mental Retardation • Mood Disorders • Psychiatry • Schizophrenia

PATIENT SATISFACTION WITH 6-MONTH PALIPERIDONE PALMITATE VERSUS OTHER LONG- ACTING INJECTABLE ANTIPSYCHOTICS. (EPA 2024) - "LAIs include paliperidone, aripiprazole, olanzapine, risperidone, and zuclopenthixol... Less frequent administration of LAIs may result in greater patient satisfaction and be just as beneficial clinically. Treatment satisfaction is positively associated with an improvement in psychotic symptoms and seems to be related to better adherence."

Clinical • CNS Disorders • Psychiatry • Schizophrenia

Reaching the limits of antipsychotic treatment: the upper end of severe schizophrenia in forensic institutions - a case report (EPA 2024) - "Therapeutic attempts with an antipsychotic combination of risperidone, olanzapine and quetiapine as well as valproic acid resulted in insufficient recovery with persistent physical assaults and florid psychosis...As from the beginning of this year a switch of medication by gradually replacing risperidone and zuclopenthixol with haloperidol and clozapine showed modest success...However, regular tonic-eye fits require supplementary treatment with biperiden, and the patient still presents frequent periods of self-harm punching himself, verbal lack of impulse control and the psychopathological phenomenona described before... Certainly, the present case is exemplary for a severely ill population of patients reaching – after a long and untreated course of disease - a chronic stage that does not sufficiently respond to a multitude of treatment attempts despite proper compliance raising the urgent need for further treatment options."

Clinical • CNS Disorders • Psychiatry • Schizophrenia

Patterns of antipsychotic prescription in inpatient and outpatient psychiatric settings: a real world study (EPA 2024) - "The most prescribed were aripiprazole (30.5%), quetiapine (21.2%) and olanzapine (15.2%); while the most prescribed FGAs were haloperidol (5.3%), zuclopenthixol (2%) and chlorpromazine (1.3%). Patients treated with SGAs have a shorter duration of untreated illness and also lower chance of lifetime hospitalization and involuntary commitment."

Clinical • Real-world • Real-world evidence • Bipolar Disorder • CNS Disorders • Depression • Mood Disorders • Personality Disorder • Psychiatry