Posted by Jamal Spelling on February 24, 2008, at 9:09:17
In reply to Re: Dopamine receptor antagonists » Jamal Spelling, posted by yxibow on February 24, 2008, at 7:48:01
Thank you for your informative post, Jay.
There is also an oral formulation of flupentixol, known as Fluanxol, which is used in doses <= 3 mg/day to treat depression and anxiety. Years ago I used it at 0.5 mg/day for a period of 2.5 years with fantastic results. I am considering going back on it. It was the one psychotropic which I can truly say "worked" for me. I'm just scared I'll get TD or diabetes or something. I've searched PB archives and I've found posts by "dingbat" and "Ed_UK" suggesting the TD risk from low dose flupentixol is less than the diabetes risk from low dose Zyprexa. My doctor said she doesn't think I need to worry about TD at such a low dose, but I'm still scared.
Do you think TD is a serious risk factor at a dose of 0.5 mg/day flupentixol? The dose they use for psychosis is I think of the order 10 mg/day, but I stand to be corrected.
My problem is mainly that lately I get episodes which last about an hour at a time, where I become extremely depressed, pessimistic, anxious and full of rage, all at the same time. My thinking also becomes irrational in that I'll believe that certain people *hate* me etc. During these episodes I feel disconnected from reality and I also engage in acts of self-injury. Outside these episodes I'm fine. I think an AP would work well.
Flupentixol is unusual in that, at low doses at least, it has activating properties and is considered pro-motivational. That was certainly my experience with it back when I used to take it. The authors below argue that flupentixol should be classified as a partial atypical.
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Kühn K. U., Meyer K., and Maier W.,
Flupenthixol--a partial atypical neuroleptic?,
Fortschritte der Neurologie-Psychiatrie 68 Suppl 1:S38-41,
2000.Abstract:
There is no really clear-cut definition for "atypical" neuroleptics. The most convincing definition is draft by characterization of the receptor-binding profile. Most important are: the combined antagonism of D2 and 5-HT2 receptors, the preferential binding to D4 and D3 receptors and a balanced relation of D2 to D1 antagonism. Flupentixol fits into this description as well as some modern neuroleptics widely considered as "atypical" neuroleptics. Clinical criteria--like the absence of EPMS and the improvement of negative symptoms--offer no clear-cut distinction between "typical" and "atypical" neuroleptics, too, because some modern "atypical" neuroleptics lead--dose-dependent--to EPMS, and there is no proven efficacy for some atypical neuroleptics in the treatment of negative symptoms. So, neuroleptics are labelled "atypical" if there is a favourable relation between antipsychotic activity and the degree of EPMS, and if there is at least some efficacy in the treatment of negative symptoms. In this regard, Flupentixol has to be labelled at least a "partial atypical neuroleptic".---------------------------------
poster:Jamal Spelling
thread:814286
URL: http://www.dr-bob.org/babble/20080221/msgs/814394.html