Zuclopenthixol is an antipsychotic medication that treats extreme psychosis in illnesses like schizophrenia or bipolar disorder. The drug has been in common use in many parts of the world for a number of years, but it is not available in the United States. This medicine can either be injected for immediate relief of symptoms or it may be taken in tablet form as part of long-term therapy. Like most of the antipsychotics, it has a heavy side effect profile, is not appropriate in combination with certain other medical conditions, and has a number of drug interactions.
Research on zuclopenthixol suggests that it acts by interfering with dopamine receptors. In the presence of too much dopamine, the body can react by producing psychotic symptoms. By blocking reactions between the receptors and dopamine, symptoms of psychosis often recede.
Several forms of this medication are available for use in treatment. Two types are injected intramuscularly and another comes in pill form. Zuclopenthixol decanoate and zuclopenthixol acetate are the injectable forms, and may be used for better symptom control in people with treatment compliance issues or to promote calm in the presence of extreme psychosis or mania. In contrast, zuclopenthixol dihydrochloride is available in tablets and may be more appropriate for ongoing control of symptoms.
A number of people should not use zuclopenthixol or should only use it under a doctor’s guidance. Pregnant or nursing women are advised against its use because it can cause birth defects and can be present in breast milk. Like most antipsychotics, this medication has been linked to a higher rate of sudden death in elderly patients with dementia. Those with kidney, liver or heart disease, some forms of cancer, and Parkinson’s disease are also advised to avoid this drug.
The most common side effects of zuclopenthixol are extreme sedation, drowsiness, confusion, and dry mouth. Since the drug reduces the body’s access to dopamine it risks creating tardive dyskinesias that cause unusual muscle movements. It can also result in akathisia, which creates extreme inner restlessness. These side effects don’t always cease when the drug is discontinued.
This drug can produce many additional reactions. The extensive list of potential adverse effects often explains lack of treatment compliance. Patients are advised to remain on the medication, unless they experience extreme drug allergy, seizures, cardiac symptoms, or other severe reactions. They should report all concerning side effects to the prescribing physician right away.
Zuclopenthixol also has many interactions with other drugs. This poses a particular challenge because psychotic patients are often not able to inform caregivers about other medications they use or provide details on previous illnesses or diagnoses. People administering the drug should make every effort to get a medical and drug history from family members to ascertain whether prescribing this medication might cause additional adverse effects.
