Zuclopenthixol Acetate

a) Is the medication a typical/atypical antipsychotic? Is the medication an SSRI/SNRI antidepressant?

Zuclopenthixol is a typical antipsychotic. It is a short acting injection. Initial treatment of acute psychosis, mania and exacerbation of chronic psychosis.





b) Common brand name

Clopixol Acuphase





c) Normal dose range

Dosage should be individually adjusted according to the patient's condition.
The dose range is usually 50 - 150 mg (1 - 3 mL) IM, repeated if necessary, preferably at intervals of 2 to 3 days. In some cases, an additional injection may be needed 24 to 48 hours following the first injection. The duration of treatment should not be more than 2 weeks. The maximum accumulated dosage in a course should not exceed 400 mg and the total number of injections should not exceed 4.





d) Common side effects

• Feeling dizzy or sleepy, blurred vision

• Dry mouth

• Feeling light-headed when you stand up

• Feeling shaky or restless, unusual or uncontrollable muscle movements

• Changes in weight

• Difficulty sleeping

• Feeling anxious or confused

• Fast heartbeats

• Headache

• Constipation

• Changes in sexual ability

• Producing more saliva than usual

• Breast enlargement in men

• Abnormal breast milk production

• Menstrual problems





e) Contraindications

• Acute alcohol, barbiturate or opiate intoxication.

• Circulatory collapse, depressed level of consciousness due to any cause, coma, suspected or established subcortical brain damage.

• Blood dyscrasias

• Phaeochromocytoma

• Leucopenia and/or previous agranulocytosis.






f) Special monitoring/nursing interventions

Neuroleptic Malignant Syndrome - A potentially fatal syndrome called neuroleptic malignant syndrome (NMS) has been reported on occasion with antipsychotic drugs. The syndrome is characterized by muscle rigidity, fever, hyperthermia, altered consciousness and autonomic instability (e.g. tachycardia, labile blood pressure, profuse sweating). The management of neuroleptic malignant syndrome should include immediate discontinuation of antipsychotic drugs, intensive monitoring of symptoms and treatment of any associated medical problems. Symptoms may persist for more than a week after oral neuroleptics are discontinued and somewhat longer when associated with the depot forms of the drugs.



Reduced hepatic function - Clopixol should be used with caution in patients with liver disease. Patients with compromised hepatic function should be given half the recommended dose and serum levels monitored



Reduced renal function - Since only about 0.1% of a Zuclopenthixol dose is excreted unchanged via the renal system, patients with mild to moderate renal dysfunction can receive Clopixol in the usual dosage. In patients with renal failure the dosage should be reduced to half the usual dose and close monitoring instituted.






g) Education requirements for patients/families/carers

Suicide – The possibility of a suicide attempt is inherent in schizophrenia and bipolar disorder, and close supervision of high-risk patients should accompany therapy.



Photosensitivity reactions - Photosensitivity reactions have been reported with related drugs.