Thiothixene, commonly known as Navane, is an antipsychotic medication used to treat delusions and hallucinations associated with schizophrenia. There are potential side effects and adverse interactions.

Thiothixene brand names

Thiothixene is available as generic or under the name brand Navane.

What is thiothixene prescribed for?

Thiothixene is approved by the U.S. Food and Drug Administration (FDA) for treating symptoms of schizophrenia in adults. It can reduce the hallucinations and delusions of the disorder, making daily life manageable.[6]

Thiothixene carries a warning label advising against use for psychotic symptoms associated with dementia patients.

Children under the age of 12 should not take thiothixene. 

How does thiothixene work?

It is unclear exactly why thiothixene works in managing psychosis. Some experts believe that psychosis is caused by levels of certain neurochemicals in the brain becoming too high due to over-excitability of the brain.

Thiothixene reduces the amounts of these neurotransmitters to normal levels.[6]

Thiothixene can help to reduce symptoms to a manageable level when taken consistently but is not a cure for schizophrenia.

How is thiothixene usually taken?

Generic thiothixene and its brand name Navane are only available by prescription and should be taken as prescribed. This medication is taken orally by capsule up to 3 times daily.

Thiothixene is typically started at a low dose and gradually increased until therapeutic benefits are reached [6]. Capsules are available in several dosages.

Avoid altering or tampering with the capsules. Doing so will affect the dosage and medication's effectiveness.

Take this medication around the same time every day. Try taking this medication with food if stomach upset occurs on an empty stomach.

It may take several weeks before noticing symptoms improve.

Take missed doses as soon as possible unless it is near time for the next dose. Do not take two doses of thiothixene at the same time.

Symptoms are likely to return if thiothixene use is ceased. Do not stop taking this medication once symptoms have subsided without medical advice from your doctor.

Suddenly stopping thiothixene can cause uncomfortable withdrawal symptoms. The doctor will likely titrate the dosage down to avoid this.

Withdrawal symptoms may include:

  • Gastrointestinal upset - nausea, diarrhea, stomach pain
  • Dizziness

How long does thiothixene stay in your system?

Thiothixene has a half-life of 10-20 hours, meaning that it takes approximately 40 hours from the time of the last dose to clear from the system. 

The liver is primarily responsible for metabolizing this medicine. Thiothixene is distributed into body tissue and can take several weeks to be fully undetectable in the system.[2]

Thiothixene side effects

Antipsychotic medications, including thiothixene, can cause serious side effects. It is critical to take these medications exactly as prescribed and report any adverse effects to the doctor quickly.

To prevent far-reaching complications that may cause permanent damage to bodily functions, the doctor may request continued monitoring of overall health through regularly scheduled lab testing. 

Life-threatening side effects that have occurred from using thiothixene include:

  • Neuroleptic Malignant Syndrome (NMS)
  • Tardive Dyskinesia

NMS is a life-threatening syndrome requiring immediate medical care. Its symptoms include [3]:

  • High fever
  • Muscle rigidity
  • Changes in mental state
  • Irregular autonomic processes such as heart rate and blood pressure 

Tardive dyskinesia is a syndrome with symptoms including involuntary movements such as chewing, grimacing, tongue movements, or blinking. Involuntary movements can also occur in the arms, legs, and throat.

Tardive dyskinesia is more likely to occur after extended use of antipsychotic medication, including thiothixene. It can become a permanent condition if left unaddressed [3].

Additional thiothixene side effects include [6]:

  • Lightheadedness/dizziness
  • Blurred vision
  • Dry mouth or increased saliva
  • Nasal congestion
  • Gastrointestinal distress - nausea, vomiting, constipation, or diarrhea
  • Appetite and weight changes
  • Increased thirst
  • Flat affect 
  • Shuffling gait
  • Restlessness and agitation
  • Sleep disturbance
  • Swelling in the extremities
  • Menstrual cycle changes
  • Impotence
  • Muscle weakness

Thiothixene and other antipsychotic agejnts are known to increase prolactin levels in the body. These increases can lead to the enlargement of breasts (in both males and females) and the production of breast milk outside of pregnancy in females [6].

As with any prescription medication, thiothixene may cause an allergic reaction. Signs of an allergic reaction include:

  • Development of a rash or hives
  • Itching
  • Fever
  • Changes in heart rate
  • Difficulty breathing

Seek immediate medical attention if an allergic reaction occurs when taking thiothixene.

Thiothixene precautions

Before taking thiothixene, discuss with the doctor all prescription medications, over-the-counter medicines, vitamins, and herbal supplements. Adverse interactions can occur when taking certain drugs concurrently with this medicine.

Share past and present medical conditions, as well as family medical history, with the doctor before taking thiothixene. People with certain risk factors may experience severe complications.

The doctor may request bloodwork to ensure there are no underlying medical conditions. 

Those with the following diseases, or who are at risk of these diseases, may not be suitable candidates for thiothixene use [5]:

  • cardiovascular diseases
  • low white blood cell counts
  • breast cancer (or a history of breast cancer)
  • seizure disorders 
  • liver problems 

Older adults with dementia should not be treated with thiothixene unless it is under close medical monitoring. Elderly patients taking antipsychotic medication are at a higher risk for sudden death.

Avoid alcohol consumption while taking this medication. Consuming alcohol with thiothixene can exacerbate drowsiness and depressant effects of alcohol. [5]

Thiothixene may invalidate home pregnancy tests. Seek a medical professional for alternative testing if pregnancy needs to be determined while taking this medicine. [6]

Thiothixene may not be appropriate for those who are pregnant or who may become pregnant. Discuss the pregnancy with the doctor before stopping this medication. [6]

Thiothixene may not be appropriate while breastfeeding.

Avoid excessive heat or time spent in direct sunlight. Thiothixene may cause decreased sweating, creating a higher risk for heat stroke, and hypersensitivity to sunlight. [6]

Avoid operating heavy machinery, including driving a vehicle, until the effects of thiothixene are known.

Thiothixene interactions

Thiothixene, and its name-brand Navane, is known to have adverse interactions with other medications, vitamins, and herbal supplements. These interactions may be life-threatening.

Other medications that cause drowsiness or depress the central nervous system can cause dangerous effects when taken with thiothixene. This includes alcohol.[5]

The FDA has issued a safety warning against the concurrent use of antipsychotics (including thiothixene) with benzodiazepines, opioids, and central nervous system depressants.[1] Mixing these medications can cause unresponsiveness and possible death.

Other medications that can cause adverse reactions with thiothixene are [4]:

  • Other antipsychotic drugs
  • Abilify, Haldol, Latuda, or Seroquel

Vitamins and supplements to avoid, unless recommended by the doctor, are [4]:

  • Vitamin D3
  • Fish Oil
  • St. John's Wort 
  • Iron Sulfate

Thiothixene storage

Thiothixene should be stored at room temperature in a tightly closed container away from excess heat and moisture.

Always store medicines away from children, teenagers, and pets to prevent accidental ingestion or prescription medication misuse. Remember that daily pill counters often do not have child-safe lids.

Speak with the medical provider about disposing of any unused medication. Avoid flushing thiothixene down the toilet or throwing it in the trash.

What to do if you overdose on thiothixene

An overdose of thiothixene, especially if taken with other substances, can be fatal. Emergency medical attention is needed if an overdose has occurred.

Signs that an overdose on thiothixene has occurred are [3]:

  • Uncontrolled muscle movements and spasms
  • Drowsiness, difficulty staying awake
  • Dizziness
  • Tight neck muscles
  • Difficulty walking
  • Coma/ unresponsiveness
  • Muscle stiffness
  • Trouble breathing or swallowing

The poison control helpline at 1-800-222-1222 can provide additional information in case of an overdose. 

FAQs

How long does it take for thiothixene to start working?

Thiothixene is usually prescribed at a lower dose and gradually increased to allow the body to adjust. It takes time for the medicine to build up in the body's system to achieve therapeutic results. 

People taking this medication generally see improvements after 2 to 4 weeks of taking the medication as prescribed.

Resources:

  1. Center for Drug Evaluation and Research. (2017, September 20). FDA Drug Safety Communication: FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines; requires its strongest warning. U.S. Food And Drug Administration. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-warns-about-serious-risks-and-death-when-combining-opioid-pain-or
  2. National Center for Biotechnology Information (2022). PubChem Annotation Record for Thiothixene, Source: Hazardous Substances Data Bank (HSDB). Retrieved November 2, 2022 from https://pubchem.ncbi.nlm.nih.gov.
  3. Pfizer. (2009, June). NAVANE®. U.S. Food And Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/016584s059lbl.pdf
  4. Thiothixene Interactions. (n.d.). Drugs.com. Retrieved November 2, 2022, from https://www.drugs.com/drug-interactions/thiothixene.html
  5. Thiothixene. (n.d.). Drugs.com. Retrieved November 2, 2022, from https://www.drugs.com/mtm/thiothixene.html
  6. Thiothixene: MedlinePlus Drug Information. (n.d.). Retrieved November 2, 2022, from https://medlineplus.gov/druginfo/meds/a682867.html