Clopixol (zuclopenthixol) / Lundbeck - LARVOL DELTA

Zuclopenthixol acetate for acute schizophrenia and similar major mental illnesses. (PubMed, Cochrane Database Syst Rev) - "Based on the evidence in this review, there may be no difference between zuclopenthixol acetate and standard medications in the management of acute psychiatric symptoms, tranquillisation and adverse events. Zuclopenthixol acetate was probably associated with a greater degree of sedation at 24 and 48 hours of administration. The use of zuclopenthixol acetate may be associated with a lower requirement for adjunctive benzodiazepines, but this is uncertain. Doses of zuclopenthixol acetate of 25 mg to 50 mg per injection may be as effective as doses of 50 mg to 100 mg per injection (very low-certainty evidence). Recommendations favouring zuclopenthixol acetate over standard medications for the management of acute behavioural disturbance should be interpreted with caution, given the methodological limitations of most included studies."

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

Zuclopenthixol and clozapine-induced neutropenia. (PubMed, BMJ Case Rep) - "We highlight a case of zuclopenthixol-induced neutropenia, a rarely reported adverse effect (AE), and subsequent susceptibility to clozapine-induced neutropenia. Investigations excluded infective, autoimmune, nutritional and primary haematological causes.The patient was subsequently established on amisulpride and lithium, with recovery of ANC. This case highlights the potential susceptibility to antipsychotic-induced neutropenia and the consideration of lithium for augmentation of ANC in future therapy."

Journal • CNS Disorders • Eosinophilia • Hematological Disorders • Immunology • Neutropenia • Psychiatry • Schizophrenia

Seizures associated with clozapine augmentation by other antipsychotics: a pharmacovigilance-pharmacodynamic analysis using VigiBase. (PubMed, Ther Adv Psychopharmacol) - "Among antipsychotics classified under ATC code N05A, DDIs with clozapine were detected for amisulpride, chlorpromazine, haloperidol, lurasidone, olanzapine, penfluridol, risperidone, sulpiride, zotepine, and zuclopenthixol. These findings suggest a potential role of dopamine D4 receptor occupancy in seizures associated with clozapine augmentation by other antipsychotics. Further large-scale epidemiological studies are needed to validate these findings."

Adverse events • Journal • PK/PD data • CNS Disorders • Epilepsy • Psychiatry • Schizophrenia

Enhancing safety and compliance in acute behavioural disturbance management: Pilot of proposed update to zuclopenthixol acetate guidelines in a regional PICU. (PubMed, Australas Psychiatry) - "Improvements were consistent across patient demographics, except for higher discharge ECG completion in non-Indigenous patients (p = .04).ConclusionsImplementation of the proposed ABDM guideline markedly improved monitoring and documentation of ZA use. These findings provide evidence for state-wide adoption to support safer and more consistent care."

Compliance • Journal • Anesthesia • CNS Disorders • Critical care • Psychiatry

DREAMS-Phen: Study Comparing Antipsychotic Dose Reduction vs. Maintenance Treatment in Patients With Schizophrenia Spectrum Disorder: a Personalized Medicine Approach (clinicaltrials.gov) - P2 | N=288 | Not yet recruiting | Sponsor: University Hospital, Strasbourg, France | Initiation date: Jan 2026 ➔ Oct 2026

Trial initiation date • CNS Disorders • Psychiatry • Schizophrenia

RAKGEORREC: Τhe Combination of Pharmacotherapy With RECOVERYTRSGR and RECOVERYTRSBDGR. (clinicaltrials.gov) - P4 | N=84 | Active, not recruiting | Sponsor: Dr. Stavroula Rakitzi | Recruiting ➔ Active, not recruiting | N=40 ➔ 84

Enrollment change • Enrollment closed • Bipolar Disorder • CNS Disorders • Mood Disorders • Psychiatry • Schizophrenia

Zuclopenthixol inhibits residual activity of acid sphingomyelinase in Niemann pick disease type B: a case report with in vitro validation. (PubMed, Orphanet J Rare Dis) - No abstract available

Journal • Preclinical • Frontotemporal Lobar Degeneration • Genetic Disorders • Lysosomal Storage Diseases • Metabolic Disorders

Effect of psychotropic medications on suicide-related outcomes: a systematic review and meta-analysis of observational studies. (PubMed, EClinicalMedicine) - "Across the main diagnostic categories and 70 individual medications examined, associations with reducing risk of suicide mortality were found for second generation antipsychotics in schizophrenia spectrum disorders: clozapine (OR = 0.40; 0.36-0.60; I2 = 60%, moderate certainty), olanzapine (OR = 0.53; 0.39-0.71; I2 = 34%, high certainty), quetiapine (OR = 0.75; 0.58-0.96; I2 = 0%, high certainty), and zuclopenthixol (OR = 0.44; 0.30-0.63; I2 = 0%, high certainty). In schizophrenia, second generation antipsychotics were also associated with reduced risks of suicide attempts: olanzapine (OR = 0.76; 0.60-0.98; I2 = 84%, moderate certainty) and risperidone (OR = 0.61; 0.52-0.72; I2 = 57%, moderate certainty)...Findings are not causal, and limitations include the observational nature of included studies, risk of residual confounding, high heterogeneity for some outcomes, and moderate quality of the evidence. University of Oxford (Hill Foundation), NIHR Oxford Health..."

Journal • Observational data • Retrospective data • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • Bipolar Disorder • CNS Disorders • Depression • Mental Retardation • Mood Disorders • Personality Disorder • Psychiatry • Schizophrenia

Comparison of Typical and Atypical Long-Acting Antipsychotics in a Real-World Sample in terms of Treatment Adherence and Factors Influencing Treatment Choice: A One-Year Follow-Up Study. (PubMed, Noro Psikiyatr Ars) - "Adherence was particularly higher with long-acting (LA) aripiprazole and LA paliperidone compared to the other three LAIs (haloperidol, risperidone, and zuclopenthixol) (p<0.05)...Adherence to LAIs administered every four weeks was higher than those administered every two weeks (p=0.014). For patients expected to face challenges with adherence to LAIs, second-generation agents with longer administration intervals may be preferred."

Journal • Real-world evidence • Bipolar Disorder • CNS Disorders • Mental Retardation • Mood Disorders • Psychiatry • Schizophrenia

Greenness, Blueness, and Whiteness Assessment of Novel Chromatographic Methods for Separation and Simultaneous Analysis of Zuclopenthixol and Its Major Potentially Toxic Impurity: A Comparative Study. (PubMed, Biomed Chromatogr) - "The practicality of the analytical methods was evaluated using the Blue Applicability Grade Index. Additionally, the analytical whiteness was determined via the RGB algorithm."

Clinical • Journal • Bipolar Disorder • CNS Disorders • Mood Disorders • Psychiatry • Schizophrenia

Priapism following antipsychotic-gabapentinoid combination in a case of treatment-resistant schizophrenia: a case report. (PubMed, BMC Psychiatry) - "Priapism requires urgent recognition and management to prevent long-term complications. In psychiatric settings, clinicians should exercise caution when combining gabapentinoids alongside antipsychotics, as this may increase the risk of priapism. This case highlights the need for careful monitoring when prescribing gabapentinoids to patients on long-term antipsychotics, particularly in psychiatric inpatient settings where delayed recognition may increase morbidity."

Journal • CNS Disorders • Critical care • Neuralgia • Pain • Psychiatry • Schizophrenia

Clozapine rechallenge after clozapine-induced myocarditis: A case report to validate a previously published protocol. (PubMed, Ment Health Clin) - "This case differed from the previously published research protocol in some respects, including the concurrent use of zuclopenthixol for antiaggression and no significant eosinophil-related concerns during monitoring. Limitations of the case include unknown postdischarge outcomes and lack of measurement-based care, such as the use of rating scales, to assess treatment response objectively. This case report validates the previously published protocol and contributes to the literature on CIM rechallenge, helping clinicians weigh the risks and benefits of rechallenging clozapine in select patients."

Journal • Cardiovascular • CNS Disorders • Dermatology • Inflammation • Psychiatry • Schizophrenia

POSSIBILITIES OF PSYCHOPHARMACOLOGICAL CORRECTION OF BEHAVIORAL DISORDERS ACCORDING TO THE HYSTEROSHIZOID TYPE OF PATIENTS WITH A CONSTITUTIONAL RANGE OF PERSONALITY DISORDERS (WCN 2025) - "Consequently,in patients with a constitutional range of PH,hysteroschizoid behavioral disorders statistically reliably confirm the psychopharmacorrective efficacy of a combination of quetiapine and clopixol depot.In the case of persistent and pronounced hysteroschizoid behavioral symptoms, statistically effective psychopharmacological correction may be limited to a combination of quetiapine and double administration of clopixol-akufaz."

Clinical • Behavior Disorders • CNS Disorders • Mental Retardation • Mood Disorders • Personality Disorder • Psychiatry • Schizophrenia

POSSIBILITIES OF PSYCHOPHARMACOLOGICAL CORRECTION OF BEHAVIORAL DISORDERS OF THE HYSTEROSCHIZOID TYPE IN PATIENTS WITH A CONSTITUTIONAL RANGE OF BORDERLINE ABNORMAL PERSONALITY (WCN 2025) - "Thus,the greatest effectiveness of psychopharmacorrection of unstable and abortive behavioral hysteroschizoid disorders in patients with a constitutional PAL range is observed when using a low dose of 25 mg of quetiapine in combination with a double parenteral administration of clopixol-akufaz."

Clinical • Behavior Disorders • CNS Disorders • Mental Retardation • Psychiatry • Schizophrenia

Antipsychotic use and risk for hip fracture in individuals with and without schizophrenia: a population-based nested case-control cohort study (ECNP 2025) - "Finally, individual antipsychotic agents were extracted and analyzed to show which has higher odds for hip fracture, while the reference group was Olanzapine...Among the antipsychotic agents odds were significantly higher with the use of Haloperidol and Zuclopenthixol (OR 1.42; 95% CI=1.26-1.62, OR 1.28; 96% CI=1.12-1.48, respectively)... Our findings suggest that both schizophrenia and antipsychotic treatment independently increase the risk of hip fractures, with the highest risk observed among patients treated with antipsychotics regardless of schizophrenia diagnosis. These results highlight the need for clinicians to evaluate fracture risk when prescribing antipsychotics, particularly for off-label indications. Further studies are needed to investigate underlying mechanisms and guide risk-reduction strategies such as bone health monitoring and fall prevention."

Clinical • CNS Disorders • Psychiatry • Schizophrenia • DRD2

A case of creutzfeldt-jakob disease presenting with psychiatric symptoms (ECNP 2025) - "He received quetiapine 300 mg/day orally and risperidone drops 2 mg/2 cc, along with two injections of zuclopenthixol acetate (50 mg/ml). Psychiatric symptoms are common in both sCJD and variant CJD and may include psychosis, depressive symptoms, suicidal ideation, anhedonia, anxiety, delusions, and catatonia. Although psychiatric symptoms have traditionally been considered rare, current literature suggests a higher prevalence [5]."

Clinical • Alzheimer's Disease • Ataxia • CNS Disorders • Cognitive Disorders • Dementia • Depression • Mood Disorders • Movement Disorders • Psychiatry • Sleep Disorder • Suicidal Ideation • CRP • PRNP

Delirious mania with catatonic features as a presenting syndrome of anti-NMDAR encephalitis: a case report (ECNP 2025) - "Despite sequential trials of olanzapine (up to 20 mg/day), quetiapine XR (up to 300 mg/day), zuclopenthixol decanoate (150 mg intramuscular every months), paliperidone (6 mg/day), and adjunctive lithium carbonate (900 mg/day, there was no clinical improvement...Rituximab was started for long-term immunomodulation, maintaining remission over one year...ConclusionA comprehensive neurodiagnostic evaluation enables early diagnosis and treatment of anti-NMDAR encephalitis. Clinicians should consider autoimmune causes in atypical neuropsychiatric cases.[5]"

Case report • Clinical • Ataxia • Bipolar Disorder • CNS Disorders • Epilepsy • Mental Retardation • Mood Disorders • Movement Disorders • Psychiatry

Prescribing patterns of antipsychotic monotherapy and polypharmacy in patients with psychotic disorders (ECNP 2025) - "Among monotherapy patients, olanzapine was most frequently prescribed (33.3%), followed by risperidone and haloperidol (both 18.2%), quetiapine (15.2%), aripiprazole (9.1%), and clozapine (6.1%)...Less frequently prescribed in polytherapy were aripiprazole (10.4%), risperidone (7.3%), levomepromazine and zuclopenthixol (both 6.3%), fluphenazine (4.2%), and amisulpride and sulpiride (both 1.0%)... Despite guideline recommendations that advocate for antipsychotic monotherapy whenever possible [1,3], this study found that polypharmacy remains prevalent in clinical practice. Olanzapine emerged as the most common choice in monotherapy regimens, while haloperidol and promazine were more frequently used in polytherapy. Clozapine, despite its well-established role in treatment-resistant schizophrenia, was more commonly prescribed as part of combination therapy (16.7%) than as monotherapy (6.1%)."

Clinical • Monotherapy • CNS Disorders • Psychiatry • Schizophrenia

Psychiatric manifestations of metachromatic leukodystrophy: a differential for atypical presentations of psychosis? (ECNP 2025) - "During his admission he was trialled on quetiapine, clozapine and zuclopenthixol depot. Diagnosing adult-onset MLD can be notoriously difficult due to the plethora of investigations required and there are often long delays between first presentation and appropriate treatment [5]. Whilst MLD is a rare cause of psychosis, this case illustrates how it may be considered as a differential diagnosis in atypical first presentations of psychosis."

CNS Disorders • Mental Retardation • Psychiatry

Pharmacological treatment among involuntary psychiatric patients: real-world patterns of polypharmacy (ECNP 2025) - "Benzodiazepines were prescribed to 13 participants including diazepamum (54%, n=7), clonazepamum (31%, n=4), and lorazepamum (15%, n=2). Mood stabilizers such as acidum valproic, carbamazepine and oxcarbazepine were used by 58% (n=51) of the study participants...The most observed polypharmacy combinations included: haloperidol + zuclopenthixol depot + clozapine + cyclodol (n=4), haloperidol + zuclopenthixol depot + Acidum Valproic + cyclodol (n=4), and haloperidol + quetiapine + cyclodol (n=3)... The study results highlight a high prevalence of polypharmacy among involuntarily treated patients. In our study BNF coefficient results exceeded recommended daily limits raising concerns about prescribed medication safety, tolerability and therapy adherence. The results reflect the need to establish psychiatric hospitals' recommendations that optimize therapeutic interventions for involuntarily admitted patients ensuring a balance between clinical effectiveness and rational..."

Clinical • Real-world • Real-world evidence • CNS Disorders • Psychiatry • Schizophrenia

Antipsychotics and other risk factors for mortality among people with schizophrenia during an extreme heat event: a population-based case-control study. (PubMed, Sci Rep) - "Dispensation of any antipsychotic was associated with increased EHE mortality [OR 2.43, 95% CI 1.52, 4.01], which was driven by haloperidol, clozapine, and zuclopenthixol. There were also significant non-pharmaceutical risk factors. People with schizophrenia are at-risk during EHEs due to multiple overlapping factors, including antipsychotic medications."

Journal • CNS Disorders • Psychiatry • Schizophrenia

Strategic and tactic use of antipsychotic medications in schizophrenia: a perspective on current prescription practice. (PubMed, Discov Ment Health) - "Meta-analyses indicate clozapine, amisulpride, olanzapine, and risperidone as effective in acute settings, with olanzapine and haloperidol beneficial for SZ-related agitation. Empirical observations suggest higher potency APs, like olanzapine and haloperidol, are more effective in acute psychosis, with zuclopenthixol also advantageous for its sedative properties...Once the acute phase resolved, patients should be gradually switched towards a medication with fewer side effects (i.e. metabolic syndrome, extrapyramidal symptoms, hyperprolactinemia) and a potential efficacy on negative symptoms and personal functioning (i.e. cariprazine, low-dose amisulpride, lurasidone, aripiprazole, brexpiprazole), to be continued in the long term, defined as a strategic AP. This approach aligns with empirical observations and aims to refine schizophrenia care through phase-specific APs use, necessitating further studies to validate its efficacy."

Journal • Review • Anesthesia • CNS Disorders • Metabolic Disorders • Psychiatry • Psychomotor Agitation • Schizophrenia

Use of TLC and Computational Methods to Determine Lipophilicity Parameters of Selected Neuroleptics: Comparison of Experimental and Theoretical Studies. (PubMed, Pharmaceuticals (Basel)) - "Aim: Taking into account the importance of this parameter, we aimed to assess and compare the utility of a hybrid procedure based on calculation methods and an experimental one for rapid and simple estimation of the lipophilicity of selected neuroleptics such as fluphenazine, triflupromazine, trifluoperazine, flupentixol and zuclopenthixol and their potential new derivatives. Our results provide a confident proposal of optimal chromatographic conditions to experimentally determine the lipophilicity of neuroleptic drugs, including new derivatives. Additionally, for the first time, the paper shows the application of selected topological indices in determining lipophilicity factors and other ADMET parameters of neuroleptics and, in the future, the newly synthesized quinoline derivatives of the studied compounds."

Journal

Correlations between receptor occupancy change and mental state in patients using long-acting injectable antipsychotics: MIDILIA pilot study. (PubMed, BJPsych Open) - "Our novel observational study design has been demonstrated to be feasible and practicable. Faster reductions in D2 occupancy may increase the risk of increased positive psychotic symptoms and irritability. Slower reductions may minimise this effect. Further recruitment is required before this can be confirmed."

Journal • CNS Disorders • Psychiatry

DREAMS-Phen: Study Comparing Antipsychotic Dose Reduction vs. Maintenance Treatment in Patients With Schizophrenia Spectrum Disorder: a Personalized Medicine Approach (clinicaltrials.gov) - P2 | N=288 | Not yet recruiting | Sponsor: University Hospital, Strasbourg, France

New P2 trial • CNS Disorders • Psychiatry • Schizophrenia