Cis(Z)-flupentixol decanoate is a potent nonsedative neuroleptic of the thioxanthene group with a rapid onset of antipsychotic, alerting and anxiolytic effects. The antipsychotic effect of neuroleptics is normally related to their dopamine receptor-blocking effect, which seems to release a chain reaction as other transmitter systems are influenced as well. Its alerting effect makes it particularly useful in the treatment of psychotic patients, who are withdrawn, apathetic, anergic or depressed, or in whom neuroleptics with a marked sedative effect cause fatigue or drowsiness.
In patients who refuse to take drugs and in outpatients who are unreliable in taking oral medication on their own, it is advantageous to change to cis(Z)-flupentixol decanoate which permits continuous antipsychotic treatment and thus prevents the frequent relapses caused by failure to take oral medication.
Pharmacokinetics: Pharmacokinetic and clinical studies have shown that cis(Z)-flupentixol injections can be given with intervals of 2-4 weeks. Its maximum serum concentration is reached by the end of the 1st week after injection. After enzymatic breakdown, the active component, cis(Z)-flupentixol, is distributed, metabolized and excreted as described previously.
The serum concentration curve declines exponentially with a half-life of 17 days reflecting the rate of release from the depot.