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Typical depot antipsychotic

Flupentixol decanoate

Brand names: Depixol, Modecate

Adult dose

Dose: Test dose 20mg IM; usual 50mg every 4 weeks (range 50–300mg every 1–4 weeks; max 400mg/week)
Route: Deep IM
Frequency: every 1–4 weeks

Clinical pearls

  • Maintenance treatment in schizophrenia, particularly where adherence is an issue

Contraindications

  • Excitable/overactive states
  • Phaeochromocytoma
  • Subcortical brain damage
  • CNS depression
  • Severe cardiovascular disease

Side effects

  • EPSE
  • Tardive dyskinesia
  • Sedation
  • Anticholinergic effects
  • Hyperprolactinaemia
  • Injection site reactions

Interactions

  • QT-prolonging drugs
  • Lithium (neurotoxicity)
  • CNS depressants

Monitoring

  • BP
  • Weight
  • Glucose
  • Lipids
  • ECG
  • Prolactin

Reference: BNF; Maudsley Prescribing Guidelines; https://bnf.nice.org.uk/drugs/flupentixol-decanoate/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.