From the Research
The most common adverse reaction from Fluanxol Depot (flupentixol decanoate) is extrapyramidal symptoms (EPS), which include akathisia, dystonia, parkinsonism, and tardive dyskinesia, as reported in a study published in 2021 1.
Key Points
- Extrapyramidal symptoms (EPS) are a common adverse effect of antipsychotics, including flupentixol decanoate.
- The risk of EPS is dose-dependent, so using the lowest effective dose is recommended.
- Other frequent adverse reactions include sedation, hyperprolactinemia, anticholinergic effects, and injection site reactions.
- Patients should be monitored regularly for these side effects, particularly EPS, which may require dose adjustment or anticholinergic medication for management.
Evidence
The study published in 2021 1 found that EPS peaked at month 3 in patients with first-episode schizophrenia treated with flupenthixol decanoate. Another study published in 2022 2 compared the severity of EPS among different antipsychotic groups and found that risperidone was associated with higher ESRS scores compared to other medications. A systematic review and meta-analysis published in 2021 3 found that the pooled prevalence of antipsychotic-induced EPSEs was 37% (95% CI: 18-55%).
Management
Patients should be monitored regularly for EPS and other adverse reactions, and the dose of flupentixol decanoate should be adjusted accordingly. Anticholinergic medication may be necessary to manage EPS. Weight gain and metabolic changes can also occur with long-term use, and patients should be monitored for these effects.
Recommendation
Based on the evidence, it is recommended to use the lowest effective dose of flupentixol decanoate and to monitor patients regularly for EPS and other adverse reactions 1, 2, 3.