Zuclopenthixol is an antipsychotic drug used to treat schizophrenia. It is important to take this medication exactly as prescribed, and report any side effects to your doctor, as some side effects can be serious

Zuclopenthixol brand names

Zuclopenthixol is not approved by the FDA for sale in the United States. It is available internationally under the following brand names:

  • Clopixol
  • Clopixol Acuphase
  • Clopixol Concentrate
  • Cisordinol

What is zuclopenthixol prescribed for?

As an antipsychotic medication, zuclopenthixol is most commonly prescribed in the treatment of schizophrenia. It may also be used to treat symptoms of psychosis that occur during episodes of mania in bipolar disorder. Zuclopenthixol is sometimes used to treat patients in psychiatric crises, but doctors use caution when prescribing zuclopenthixol for this purpose, as there is a lack of research assessing the safety and effectiveness of zuclopenthixol in psychiatric emergencies [1].

How does zuclopenthixol work?

Zuclopenthixol works by blocking the activity of a brain chemical called dopamine, which is believed to be elevated in patients with schizophrenia. By reducing dopamine activity, zuclopenthixol and other antipsychotics are able to alleviate symptoms of psychosis [1].

How is zuclopenthixol usually taken?

Zuclopenthixol is available as both an oral tablet and a depot injection. An injection of zuclopenthixol produces effects that last for two to three days [2]. The oral form of zuclopenthixol is available as a tablet that comes in various dosages. A doctor will determine the best dose for an individual patient. The lowest oral dose that produces effective results should be used.

How long does zuclopenthixol stay in your system?

Zuclopenthixol has a relatively long half-life, of about 20 hours on average. This means that half of the initial concentration of the drug is cleared from the body within 20 hours [1]. Given that a drug is eliminated from the body within 4 to 5 half lives, you can expect zuclopenthixol to remain in the body for around 4 to 5 days.

Zuclopenthixol side effects

Just like any prescription medication, there are potential side effects with zuclopenthixol. Some common side effects of this medication include [3]:

  • Drowsiness
  • Dizziness
  • Headache
  • Confusion
  • Tremor
  • Dry mouth
  • Blurred vision
  • Lightheadedness
  • Excessive salivation
  • Slowed movement
  • Involuntary muscle movements
  • Chills
  • Agitation or restlessness 

The side effects above are generally mild and will get better with time. If you experience any adverse reactions that are severe or do not improve, talk with your doctor. They may switch you to another medication with fewer adverse effects or adjust your dosage.

Zuclopenthixol precautions

It is important to work closely with your doctor while taking zuclopenthixol. The medication should be taken exactly as prescribed, and you should closely monitor side effects. [1].

Another precaution to consider with this medication is that it has not been as well-researched as other antipsychotic medications, especially for the treatment of psychiatric emergencies [1].

Some medical conditions may make it unsafe to take zuclopenthixol. These conditions include [4]:

  • Liver or heart disease
  • Respiratory problems
  • Kidney failure
  • Epilepsy
  • Parkinson’s disease
  • Prostatic hypertrophy
  • Thyroid conditions 

Talk with your doctor if you have any of the above health conditions. Your dose may need to be altered, or you may need to be closely monitored for side effects. In some cases, your doctor will choose an alternative medication to zuclopenthixol if an existing medical condition makes it dangerous for you to take the drug.

You should avoid the use of alcohol while taking zuclopenthixol, as it can cause dangerous interaction effects with alcohol. Be sure to tell your doctor about any medications you are taking before beginning zuclopenthixol, as some medications can interact with it as well, making it less or overly effective [1].

Zuclopenthixol interactions

Numerous medications can cause interaction effects when taken alongside zuclopenthixol. While the following list is not exhaustive, it contains some of the most common medications that are known to interact with zuclopenthixol [4]

  • Barbiturates
  • Any central nervous system depressant
  • General anesthetics
  • Atropine
  • Neuromuscular blocking agents
  • Antiparkinson drugs
  • Quinidine
  • Digoxin
  • Corticosteroids
  • Lithium
  • Sibutramine
  • Metoclopramide
  • Piperazine
  • Hydralazine
  • Doxazosin
  • Tricyclic antidepressants
  • Antipsychotics - Thioridazine
  • Antihistamines
  • Moxifloxacin
  • Antihypertensives - Guanethidine
  • Cisapride
  • Sotalol
  • Amiodarone
  • Dofetilide
  • Erythromycin

Since the list above is not exhaustive, it’s critical to inform your doctor of all medications you are taking, so that they can determine if a potential interaction effect exists.

What to do if you overdose on zuclopenthixol

Zuclopenthixol should be taken exactly as prescribed by a doctor to reduce the risk of overdose. It’s also important to communicate with your doctor about other medications you are taking, as some medications can increase overdose risk when taken in combination with zuclopenthixol. 

Some signs of a zuclopenthixol overdose include [1]:

  • Convulsions
  • Dangerously low blood pressure
  • Extreme drowsiness
  • Shock
  • Either hyper or hypothermia
  • Extrapyramidal symptoms (tremor, muscle stiffness, involuntary muscle contraction)
  • Coma 

If you or someone you know has taken zuclopenthixol and are demonstrating overdose symptoms, seek immediate medical attention. It is critical to call 911 if a person has collapsed or is non-responsive after taking zuclopenthixol.

FAQ

What are the alternatives to zuclopenthixol?

Zuclopenthixol is not FDA-approved for use in the United States, which means that an alternative medication will need to be chosen for patients seeking treatment of psychosis or schizophrenia. Zuclopenthixol is a typical or first generation antipsychotic drug. Other medications in this class include trifluoperazine, perphenazine, prochlorperazine, acetophenazine, triflupromazine, mesoridazine, haloperidol, thiothixene, chlorprothixene, loxapine, molindone, and pimozide [5].

Resources:

  1. National Center for Biotechnology Information. (2022). PubChem compound summary for CID 5311507, zuclopenthixol. Retrieved November 12, 2022 from https://pubchem.ncbi.nlm.nih.gov/compound/Zuclopenthixol.
  2. Jayakody, K., Gibson, R.C., Kumar, A., & Gunadasa, S. (2012). Zuclopenthixol acetate for acute schizophrenia and similar serious mental illnesses. Cochrane Database of Systematic Reviews, 4. https://doi.org/10.1002/14651858.CD000525.pub3
  3. Bryan, E.J., Purcell, M.A., & Kumar, A. (2017). Zuclopenthixol dihydrochloride for schizophrenia. Cochrane Database of Systematic Reviews, 11. doi: 10.1002/14651858.CD005474.pub2
  4. (2022). Clopixol 200 mg/ml solution for injection. Retrieved November 12, 2022 from https://www.medicines.org.uk/emc/product/6414/smpc#gref
  5. Chokhawala, K., & Stevens, L. (2022). Antipsychotic medications. National Library of Medicine. Accessed November 12, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK519503/#:~:text=The%20first%2Dgeneration%20antipsychotics%20work,cholinergic%2C%20and%20histaminergic%20blocking%20action