Flupenthixol versus placebo for schizophrenia

Shanghai Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 11/2012; 11(11):CD009777. DOI: 10.1002/14651858.CD009777.pub2
Source: PubMed


Flupenthixol is an antipsychotic drug, first made available in the UK in 1965. Available both as a tablet and long-acting injection, it has been used to treat schizophrenia for nearly 50 years and has been found to be effective and well tolerated by people with schizophrenia. The main side-effects are shaking, restlessness, a dry mouth and some weight gain. Although this drug has been available for many years, few systematic reviews of its effectiveness are available and the effects of this drug in helping people cope with the symptoms of schizophrenia are not currently well measured, quantified and known. This systematic review could include only one small study which was small and 30 years old. Flupenthixol was compared with a placebo (dummy drug). Fewer people taking flupenthixol required additional antipsychotic medication but there was no clear difference in people’s ability to cope and function socially. There was no clear information on: improving people’s mental state; helping their behaviour; increasing their use of services; people’s satisfaction with treatment; or costs and cost effectiveness. Flupenthixol is widely available and inexpensive so it is perhaps understandable that it remains a popular drug used for treating people with serious mental illnesses. However, the use of flupenthixol is based more on clinical experience and the decisions of psychiatrists rather than results from large-scale research studies and evidence-based information. The effectiveness and benefits of flupenthixol remain largely unknown and incomplete. Large randomised and placebo-controlled trials could be helpful in increasing knowledge about this drug. This summary has been written by Ben Gray from RETHINK.

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    • "First introduced about 50 years ago, it continues to be widely prescribed by psychiatrists . A recent Cochrane review reported that there are few data from clinical trials investigating its absolute effects, and suggested that flupenthixol may well be worthy of careful investigation, partly to ensure that this inexpensive active drug is not forgotten (Shen et al. 2012). "
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