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At least 307 records · Page 17Linked to original sources
PubMed2002

Rapid tranquillisation: time for a reappraisal of options for parenteral therapy.

BACKGROUND: When parenteral treatments are indicated for acutely disturbed behaviour, previous guidelines have recommended droperidol or haloperidol in combination with benzodiazepines. However, there has been recent concern over cardiotoxicity and sudden death associated with some antipsychotic medication and droperidol has now been withdrawn. AIMS: To ascertain what alternatives can be recommended to replace intramuscular droperidol. METHOD: Selective review of current guidelines and the literature pertaining to rapid parenteral tranquillisation. RESULTS: Current guidelines recommend haloperidol as an alternative to droperidol. There is evidence of cardiotoxicity with haloperidol and it has a propensity to cause extrapyramidal side-effects that may exacerbate disturbed behaviour and reduce longer-term compliance. The rapid-acting intramuscular formulations of atypical antipsychotic agents show promise. CONCLUSIONS: It is recommended that the mainstay of pharmacological rapid tranquillisation should be parenteral benzodiazepines used with due care.

Acute Disease↗
PubMed2000

Zuclopenthixol-associated neutropenia and thrombocytopenia.

OBJECTIVE: To report a case of neutropenia and thrombocytopenia secondary to use of zuclopenthixol in a schizophrenic patient. CASE SUMMARY: A 66-year-old white man with chronic schizophrenia was referred to the hospital due to neutropenia and thrombocytopenia that developed shortly after initiation of zuclopenthixol therapy. Prior to zuclopenthixol administration, his white blood cell and platelet counts were 8.5 x 10(9) cells/L3 and 305 cells x 10(9)/L, respectively. Progressive reduction in leukocyte and platelet counts occurred, reaching a nadir of 2.9 x 10(9) cells/L3 (granulocytes 18.9%) and 109 cells x 10(9)/L, respectively. Zuclopenthixol was discontinued on admission, resulting in complete recovery within the next five days. DISCUSSION: Neutropenia and thrombocytopenia are well-known complications of antipsychotic drug therapy. Zuclopenthixol, a well-established antipsychotic agent, has relatively few adverse effects. The rapid decrease of white blood cell and platelet counts following the initiation of zuclopenthixol, as well as the rapid recovery, implicate zuclopenthixol as the predominant cause for neutropenia and thrombocytopenia in this patient. CONCLUSIONS: Although neutropenia and thrombocytopenia are rare complications of zuclopenthixol therapy, monitoring blood counts in patients receiving this agent seems to be justified.

Aged↗
PubMed2002

Priapism associated with zuclopenthixol.

OBJECTIVE: To present a single case of zuclopenthixol-induced priapism and a literature review. CASE SUMMARY: We report the case of a 31-year-old patient hospitalized due to behavioral alterations and treated with oral zuclopenthixol, an antipsychotic from the thioxanthene family, who developed an acute, painful erection. DISCUSSION: The occurrence of priapism in our patient was related to zuclopenthixol. This adverse reaction is reported for the first time in a patient not concomitantly treated with other drugs associated with the appearance of priapism. The capacity of zuclopenthixol to induce priapism is thought to be due to its antagonist activity on alpha-adrenergic receptors. CONCLUSIONS: Priapism is an uncommon but potentially serious adverse effect of zuclopenthixol that practitioners, as with many other antipsychotics, should be aware of.

Adult↗
PubMed2005

Recurrent heat-related illnesses during antipsychotic treatment.

OBJECTIVE: To report a case of recurrent heat-related illnesses associated with the use of benzhexol, chlorpromazine, and zuclopenthixol decanoate. CASE SUMMARY: During the summer of 2004, a 48-year-old man with a history of diabetes mellitus and schizophrenia was twice admitted to the hospital because of heat-related illnesses. On both occasions, he had been working under the sun in an open car park. His medications included benzhexol 2 mg twice daily, chlorpromazine 650 mg at bedtime, and zuclopenthixol decanoate intramuscular injection 600 mg every 4 weeks. In the first admission, the clinical diagnosis was heat stroke. He was discharged home on day 14, with precautionary advice against heat stroke. In the second admission, the clinical diagnosis was heat exhaustion. He was discharged home on day 4 and reminded of the precautions against heat stroke. An objective causality assessment revealed that the adverse event was possibly drug related in the first admission and probably drug related in the second admission. DISCUSSION: Several drugs can impair thermoregulation during exercise or under conditions of environmental heat stress. Anticholinergic drugs or drugs with anticholinergic effects can inhibit sweating and reduce heat elimination. Neuroleptics (antipsychotics), such as phenothiazines, have combined anticholinergic and central thermoregulatory effects. The set point of the temperature regulation center can be elevated by the antidopaminergic effect of antipsychotics, such as phenothiazines and thioxanthenes. CONCLUSIONS: Certain drugs may induce or worsen heat-related illnesses. During a heat wave, special attention should be given to those most at risk, and the importance of preventive measures should be emphasized.

Antipsychotic Agents↗
PubMedDate not supplied

An ethopharmacological assessment of the effects of zuclopenthixol on agonistic interactions in male mice.

Zuclopenthixol is a thioxanthene derivative which acts as a mixed dopamine D1/D2 receptor antagonist. Although the antiaggressive action of neuroleptic drugs is well known, the effects of zuclopenthixol on agonistic interactions have not been explored and there are no studies comparing acute and subchronic effects of this compound on aggression in rodents. In this work, we examined the action of zuclopenthixol (0.025-0.4 mg/kg), administered acutely or subchronically for 10 days, on agonistic behavior elicited by isolation in male mice. Individually housed mice were exposed to anosmic "standard opponents" 30 min after the drug administration, and encounters were videotaped and evaluated using an ethologically based analysis. After acute treatment, zuclopenthixol (0.2 and 0.4 mg/kg)-treated animals exhibited ethopharmacological profiles characterized by a decrease in offensive behaviors without impairment of motor activity (0.2 mg/kg). In contrast, the antiaggressive action of the highest dose used (0.4 mg/kg) was accompanied by a marked increase of immobility. After subchronic treatment, no tolerance to zuclopenthixol antiaggressive or motor activity was observed. Overall, this behavioral profile is similar to that observed with other typical neuroleptics.

Aggression↗
PubMed2001

Evaluation of long-term sedation in cheetah (Acinonyx jubatus) with perphenazine enanthate and zuclopenthixol acetate.

Two long-acting neuroleptics were used to tranquilize nine captive cheetahs (Acinonyx jubatus). Perphenazine enanthate (3.0 mg/kg) and zuclopenthixol acetate (0.6 mg/kg) were each administered to separate groups of three cheetahs in a double blind trial. Both products were administered together to a third group of three animals at the same dosages. Behavioral effect, duration of effect, and possible side effects were observed by a predefined protocol. Under standardized holding conditions, the cheetahs were observed 5 days before drug administration and 14 days after administration. Daily activity was defined and statistically evaluated by a U-test. A significant reduction of activity was observed after administration in all three trials. Zuclopenthixol acetate at 0.6 mg/kg alone and in combination with perphenazine enanthate caused inappetence, ataxia, extra pyramidal reactions, akathisia, and prolapse of the third eyelid. Zuclopenthixol acetate should not be used in cheetahs. Perphenazine enanthate did not cause inappetence, reduced appetite, or any of the previously mentioned side effects when used alone. It produced satisfactory tranquilization and is suitable and safe for cheetahs at 3.0 mg/kg. This dosage should be varied depending on health, age, and temperament of the individual cheetah.

Acinonyx↗
PubMed2002

Use of azaperone and zuclopenthixol acetate to facilitate translocation of white-tailed deer (Odocoileus virginianus).

Thirteen wild-caught white-tailed deer (Odocoileus virginianus) from two different holding sites were chemically immobilized to facilitate capture, processing, and translocation to a new facility. The deer were divided into two treatment groups on the basis of age and received i.m. injections of the immobilizing agents via remote drug delivery systems. Group 1 (<1 yr old; n = 6) animals were immobilized with a combination of xylazine 1 mg/kg i.m. and azaperone 0.3 mg/kg i.m. At the end of the procedure the deer received zuclopenthixol acetate 1 mg/kg i.m. and (to antagonize the xylazine) tolazoline 2 mg/kg i.m. Group 2 (>1 yr old; n = 7) deer were administered xylazine 1 mg/kg i.m.. tiletamine-zolazepam 1 mg/kg i.m., and ketamine 1 mg/kg i.m. The deer in this group received a combination of azaperone 0.3 mg/kg i.m. and zuclopenthixol acetate 1 mg/kg i.m. before reversal with tolazoline 2 mg/kg i.m. All deer were recovered in a trailer before being moved in small groups to the new facility and released into the new enclosures. Azaperone and zuclopenthixol acetate provided short- and long-term relief from anxiety and allowed the animals to gradually become familiar with their new surroundings without excitement, injuries, or mortalities. Two deer exhibited mild signs of extrapyramidal side effects, which suggests that they may have received a relative overdose of the tranquilizers.

Animals↗
PubMed2001

Flow-injection chemiluminometric determination of some thioxanthene derivatives in pharmaceutical formulations and biological fluids using the [Ru(dipy)3(2+)]-Ce(IV) system.

A flow-injection (FI) methodology using tris(2,2'-dipyridyl)ruthenium(II), [Ru(dipy)3(2+)], chemiluminescence (CL) was developed for the rapid and sensitive determination of three thioxanthene derivatives, namely zuclopenthixol hydrochloride, flupentixol hydrochloride and thiothixene. The method is based on the CL reaction of the studied thioxanthenes with [Ru(dipy)3(2+)] and Ce(IV) in a sulfuric acid medium. Under the optimum conditions, calibration graphs were obtained over the concentration ranges 0.002-6 migrograms/ml for zuclopenthixol hydrochloride, 0.5-15 micrograms/ml for flupentixol hydrochloride and 0.05-7.5 micrograms/ml for thiothixene. The limits of detection (s/n = 3) were 4.2 x 10(-9) mol/l zuclopenthixol hydrochloride, 2 x 10(-8) mol/l flupentixol hydrochloride and 4.5 x 10(-8) mol/l thiothixene. The method was successfully applied to the determination of these compounds in dosage forms and biological fluids.

Antipsychotic Agents↗
PubMed2000

Evaluation of zuclopenthixol acetate to decrease handling stress in wapiti.

Handling stress and capture myopathy are important consequences of intensively managing wildlife species. Over the last 15 yr, the use of long-acting neuroleptic (LAN) drugs in wildlife has increased, and these drugs have become a valuable tool for decreasing capture and handling stress in many species. At this time, reports on the use of these drugs in North American species are limited. The major objective of this study was to evaluate the use of the LAN, zuclopenthixol acetate (Clopixol-Acuphase), to decrease both quantifiable and subjective measurements of stress and activity in wild wapiti (Cervus elaphus, North American elk). This blinded, randomized study took place in February 1999 in Manitoba (Canada) and involved 11 animals receiving the drug and 12 animals acting as controls. At 24 hr after drug administration, there were measurable and significant decreases in the stress and activity of treated animals versus controls during handling. Treated animals had significantly lower mean body temperatures (39.0 versus 40.6 C), less hemoconcentration (mean packed cell volume 0.42 versus 0.49, mean hemoglobin 159.09 versus 181.75 g/L, mean total protein 65.0 versus 70.25 g/L), lower mean serum cortisol (97.91 versus 139.50 mmol/L), lower mean blood lactate (3.39 versus 5.98 mmol/L), and were less metabolically acidotic (mean pHv 7.45 versus 7.34, mean bicarbonate 29.36 versus 24.25 mmol/L, mean base excess 5.64 versus -0.83 mmol/L). Only control animals had evidence of muscle damage based on serum biochemistry (creatine phosphate values of two animals of 42,080 and 25,887 U/L). No animals developed clinical capture myopathy, and no animals died. Measurable effects of this drug were still apparent at 72 hr post-administration. The results of this study support the use of Clopixol-Acuphase in wapiti as a means to decrease handling stress and activity.

Animals↗
PubMed1999

[Priapism caused by simultaneous use of zuclopentixol and paroxetine].

A man aged 32 with psychotic and depressive symptoms was treated with zuclopentixol and paroxetine, following which priapism developed. After puncture of coagulated blood from the corpora cavernosa urine retention developed and a suprapubic catheter had to be introduced temporarily for urine drainage. Zuclopentixol is an alpha 1-receptor blocker and paroxetine inhibits the hepatic enzyme P450-2D6 required for conversion of the two substances. Separately, and especially in combination, these substances cause a disturbance of the drainage from the corpora cavernosa leading to ischaemia and complications such as dysuria, urine retention, impotence, fibrosis of the corpora cavernosa and gangrene. Consequently, timely treatment is indicated.

Adrenergic alpha-1 Receptor Antagonists↗
PubMed1998

A double blind comparison of zuclopenthixol acetate with haloperidol in the management of acutely disturbed schizophrenics.

The aim of this study was to evaluate the efficacy and side effects of zuclopenthixol acetate compared with haloperidol in the management of the acutely disturbed schizophrenic patient. Suitable subjects diagnosed as having schizophreniform disorder or acute exacerbation of schizophrenia admitted to the psychiatric wards Hospital Kuala Lumpur were randomised to receive either zuclopenthixol acetate or haloperidol. They were rated blind for three consecutive days using the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI) and UKU Side Effects Scale. Apart from repeat injections of the same medication, no other anti-psychotic was given for the duration of the study. 50 subjects entered the study of which 44 completed. 23 were given zuclopenthixol acetate and 21 haloperidol. Both groups significantly reduced BPRS and CGI scores on all 3 days compared to the initial rating (p < 0.001). There was however no difference between the zuclopenthixol acetate and haloperidol group scores on all days (p > 0.05). More subjects on haloperidol than zuclopenthixol required more than 1 injection during the study. Both groups had minimal side effects. Zuclopenthixol acetate was effective in the management of the acutely disturbed schizophrenic.

Adult↗
PubMed2000

Depot antipsychotics. Patient characteristics and prescribing pattern.

OBJECTIVE: To determine the prescribing pattern of depot neuroleptics and the clinical characteristics of patients attending depot clinic. METHODS: A case series of chronic psychotics attending the depot clinic in the day care center at King Abdulaziz University Hospital in Riyadh, over 10 years. Data was obtained from hospital records, patients interview and contact with patients' relatives and social workers. RESULTS: The total number of patients was 69 (55% were males). The majority were single schizophrenics between 25 and 45 years. Fifty-one percent of patients lost contact with the service. The Chlorpromazine equivalent depot dose was 188.5 mg/day. CONCLUSION: Patients clinical characteristics were not significant predictors of use or non-compliance with depot neuroleptics. Losing contact with service was very high. Regular internal audits are required.

Adult↗
PubMed2001

Comparison of analgesic techniques for antler removal in wapiti.

The purpose of this research was to compare the effectiveness of ring block anesthesia (LA) and electroanesthesia (A) for antler removal in elk given a long-acting tranquilizer to remove stress from restraint. Thirty-two male wapiti were given 1 mg/kg body weight of zuclopenthixol acetate; the next day, they were restrained in a hydraulic chute, provided with electroanesthesia or a lidocaine ring block, and had their antlers removed. Behavioral response to antler removal was scored. Significantly more (P = 0.032) animals responded to antler removal in the EA group. Heart rates and arterial pressures were measured by a catheter connected to a physiological monitor. Heart rate increased significantly over time with EA, but not with LA. Heart rate increased from baseline significantly more in the EA group immediately prior to antler removal (P = 0.017), immediately post antler removal (P = 0.001), and at 1 min post antler removal (P = 0.037). It was concluded that EA is not as effective a method of anesthesia as is LA for antler removal.

Animals↗
PubMed2002

Comparative study of the effectiveness of zuclopenthixol acetate and haloperidol in acutely disturbed psychotic patients.

OBJECTIVES: To study the effectiveness, frequency of administration and side effects of zuclopenthixol acetate (ZPTA) and haloperidol (HAL) in the treatment of acute psychotic disturbance with aggression. METHOD: Purposive sampling method was employed in a group of psychotic patients with aggression admitted to Songkla Neuropsychiatric Hospital, they were randomly divided into 2 groups: ZPTA group and HAL group. All of the patients were evaluated daily for 7 consecutive days using the Brief Psychiatric Rating Scale (BPRS) and the Clinical Global Impression Scale (CGI). Statistical analysis was performed by using the Student t-test and Linear regression. RESULTS: There were 70 patients with diagnosis of schizophrenia, mania and acute psychosis. Thirty-eight patients were randomly assigned to the ZPTA group and were given 50-100 mg of the drug, while 32 patients received HAL 5-10 mg. The result showed a significant reduction in BPRS or CGI scores in both groups. Patients treated with ZPTA required less frequent administration than did those on HAL (p < 0.05). There was no statistically significant difference in the reduction in scores between the two groups. Nor was there a statistical difference in reduction of aggression based on BPRS rating. Each group of patients showed a few side effects of mild degree. CONCLUSION: Both ZPTA and HAL were effective in the treatment of acute psychosis with aggression, but frequency of administration was lower in the ZPTA group

Acute Disease↗