Flupentixol + Melitracen

Oral
Depression

Circulatory collapse, depressed level of consciousness due to any cause, coma. Severe depressing requiring hospitalisation or electroconvulsive therapy. Not recommended for use in states of excitement or overactivity.

Unsafe in porphyria. Caution when used in patients with epilepsy; Parkinson's disease; narrow angle glaucoma; prostatic hypertrophy; hypothyroidism; hyperthyroidism; liver disease; cardiac disease or arrhythmias; severe respiratory disease; renal failure; myasthenia gravis; phaeochromocytoma. Patients with hypersensitivity to thioxanthenes or other antipsychotics. Close monitoring for changes in behaviour, suicidal thoughts or clinical worsening during the initial part of the treatment is recommended. May impair control of diabetes; monitor blood glucose in diabetics. Withdrawal should be gradual.

Drowsiness, dry mouth, constipation, vomiting, dyspepsia, diarrhoea, abdominal pain, nausea, flatulence. Extrapyramidal effects, especially in the initial phase of the treatment. Tachycardia, palpitations, prolonged QT interval, hypotension. Thrombocytopenia, neutropenia, leukopenia, agranulocytosis. Dyspnoea, myalgia, muscle rigidity, micturition disorder, urinary retention. Increased appetite and wt. Abnormal glucose tolerance and LFTs. Insomnia, depression, nervousness, agitation, libido decreased.

Increased risk of adverse effects when used with alcohol. May potentiate the effects of general anaesthetics and anticoagulants, and prolong the action of neuromuscular blockers. May increase anticholinergic effects of atropine and drugs with anticholinergic activity. May increase risk of neurotoxicity when used with sibutramine or lithium. Avoid concurrent usage with drugs that cause QT prolongation or cardiac arrhythmias. May inhibit metabolism of TCAs. May antagonise effects of adrenaline and sympathomimetics, and reverse antihypertensive effects of guanethidine.

Description: Flupentixol inhibits dopamine-mediated effects by blocking postsynaptic dopamine receptors in the CNS. Melitracen is a TCA with anxiolytic properties. At low doses, it has activating properties. It is also a bipolar thymoleptic.
Pharmacokinetics:
Absorption: Flupentixol: Readily absorbed in the GI tract.
Distribution: Flupeentixol: >95% bound to plasma proteins; widely distributed in the body and crosses the blood brain barrier.
Metabolism: Flupentixol: Extensively hepatic metabolism.
Excretion: Flupentixol: Excreted in urine and faeces in the form of many metabolites.

Antidepressants