Antipsychotics
Flupentixol
An antipsychotic for schizophrenia that can be taken as tablets or given as a long-acting 'depot' injection, with low-dose tablets also used short-term for depression.
What is Flupentixol?
Flupentixol is an antipsychotic medicine used to treat schizophrenia and other conditions with psychosis. It can be taken as tablets or given as a long-acting 'depot' injection into a muscle, which slowly releases the medicine over weeks. At low doses, flupentixol tablets are also sometimes used short-term for depression.
Education and reference only. This is a plain-language guide to Flupentixol — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Flupentixol is an antipsychotic used mainly for schizophrenia and similar conditions. A particular advantage is that it can be given as a depot — a long-acting injection into a muscle that releases the medicine slowly over a couple of weeks — which removes the need to remember daily tablets. At lower strengths, the tablet form (under the name Fluanxol) is also used as a short-term treatment for depression. It works steadily over days to weeks.
How it works
Flupentixol blocks dopamine receptors in the brain, which helps to reduce the hallucinations, delusions and disordered thinking seen in psychosis. As with other older antipsychotics, blocking dopamine can also produce movement side effects and raise the hormone prolactin. The depot injection provides a steady release of the medicine, keeping levels even between doses.
What it treats
Conditions Flupentixol is used for
Practical use
How to take Flupentixol
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- If taking tablets, take them regularly as prescribed; the dose is often taken earlier in the day as it can be slightly activating.
- If you have the depot injection, a nurse or doctor gives it into a muscle at regular intervals — keep your appointments.
- Take tablets with or without food; with a little food may ease any stomach upset.
- Do not stop suddenly — if you are coming off it, the dose is reduced gradually under medical advice.
- When used for depression, the tablet is intended only for short-term use as advised by your prescriber.
- If you miss a tablet, take it when you remember unless it is nearly time for the next one — do not double up.
Weighing it up
Advantages & disadvantages of Flupentixol
Advantages
- Available as a long-acting depot injection, which avoids the need to remember daily tablets.
- Steady medicine levels between depot doses, which can help people who find tablets hard to keep up with.
- Tends to be activating rather than heavily sedating, which suits some people.
- Low-dose tablets offer a short-term option for depression.
Disadvantages
- Can cause movement side effects (stiffness, tremor, restlessness) typical of older antipsychotics.
- Can raise the hormone prolactin, causing effects such as breast tenderness or menstrual changes.
- Because it can be activating, it is not ideal when someone is very agitated.
- Once a depot is given it cannot be removed, so side effects may persist until it wears off.
Practical use
Good to know
The depot injection is convenient because it is given every couple of weeks instead of taking tablets each day, and a healthcare professional administers it. It should not be stopped suddenly. Because it can be mildly activating rather than sedating, it is generally not the best choice for someone who is very agitated. The low-dose tablet used for depression is only for short-term use, not long-term antidepressant treatment.
Who should not take it / use with caution
- People who are very overactive or agitated, as it may make this worse.
- People with a reduced level of consciousness or central nervous system depression.
- Used with caution in heart disease, certain heart-rhythm problems, epilepsy, Parkinson's disease and significant liver or kidney problems.
- Caution in pregnancy and breastfeeding — the prescriber weighs benefit against risk.
Monitoring
- Review of mental state, response and any movement side effects.
- Weight, blood pressure and, over time, blood sugar and lipids.
- An ECG (heart tracing) may be checked where there are heart concerns or higher treatment.
Side effects
- Movement effects such as stiffness, tremor, restlessness or slowed movement.
- Raised prolactin, which can cause breast tenderness, milk production or menstrual changes.
- Restlessness or difficulty sleeping, as it can be mildly activating.
- Weight gain, dry mouth and dizziness on standing.
- Less commonly, effects on heart rhythm (QT prolongation).
- Very rarely, a serious reaction called neuroleptic malignant syndrome can occur (high fever, muscle stiffness, confusion and a fast heartbeat) — this is a medical emergency, seek urgent help.
Key interactions
- Other sedating medicines and alcohol can add to drowsiness.
- Other medicines that affect heart rhythm (QT interval) increase the risk when combined.
- Medicines for Parkinson's disease may work less well alongside it.
- Medicines that lower blood pressure can increase dizziness on standing.
Available as: Tablets and a long-acting depot injection.
Answers
Flupentixol: frequently asked questions
What is a depot injection?
It is a long-acting injection given into a muscle that releases the medicine slowly over a couple of weeks, so you do not need daily tablets.
Can flupentixol be used for depression?
Yes, low-dose tablets are sometimes used as a short-term treatment for depression, which is separate from its use for schizophrenia.
Will it make me sleepy?
It is usually less sedating than some other antipsychotics and can even be slightly activating, which is why it is often taken earlier in the day.
Can I stop it suddenly?
No. Stopping suddenly can cause symptoms to return or withdrawal effects. The dose is reduced gradually under medical advice.
How will my treatment be monitored?
Your team will review how you are doing and watch for movement side effects, and will check things like weight, blood pressure and blood tests over time.
The wider class
About Antipsychotics
Flupentixol belongs to the antipsychotics class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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