Truxal - General Information:

Truxal is a typical antipsychotic drug of the thioxanthene (tricyclic) class. Truxal exerts strong blocking effects by blocking the 5-HT2 D1, D2, D3, histamine H1, muscarinic and alpha1 adrenergic receptors.

Pharmacology:

Truxal is a typical antipsychotic drug of the thioxanthine class. It has a low antipsychotic potency (half to 2/3 of chlorpromazine). An intrinsic antidepressant effect of chlorprothixene has been discussed, but not proven yet. Likewise, it is unclear, if chlorprothixene has genuine analgesic effects. An antiemetic effect, as with most antipsychotics, exists. It is used in the treatment of nervous, mental, and emotional conditions. Improvement in such conditions is thought to result from the effect of the medicine on nerve pathways in specific areas of the brain. Truxal has a strong sedative activity with a high incidence of anticholinergic side-effects. Truxal is structurally related to chlorpromazine, with which it shares in principal all side effects. Allergic side-effects and liver damage seem to appear with an appreciable lower frequency.

Truxal for patients

The initial doses of chlorprothixene should be as low as possible (e.g. 30mg at bedtime, 15mg morning dose) and be increased gradually. Patients receiving 90mg daily (and more) of the drug should be hospitalized, particularly during the initial phase of treatment. If chlorprothixene is to be withdrawn, it should not be stopped abruptly, but the dose should be decreased steadily.

Truxal Interactions

Chlorprothixene may increase the plasma-level of concomitantly given lithium. In order to avoid lithium intoxication, lithium plasma levels should be monitored closely. If chlorprothixene is given concomitantly with opioids, the opioid dose should be reduced (by approx. 50%), because chlorprothixene amplifies the therapeutic actions and side-effects of opioids massively. Avoid the concomitant use of chlorprothixene and tramadol (Ultram). Massive seizures may be encountered with this combination. Consider additive sedative effects and confusional states to emerge, if chlorprothixene is given with benzodiazepines or barbituates. Choose particular low doses of these drugs. Exert particular caution in combining chlorprothixene with other anticholinergic drugs (tricyclic antidepressants and antiparkinsonian agents): Particularly the elderly may develop delirium, high fever, severe obstipation, even ileus and glaucoma.

Truxal Contraindications

Contraindications include alcohol abuse (adds to the central nervous system (CNS) depressant effects), blood disease, enlarged prostate, glaucoma, heart or blood vessel disease, lung disease, Parkinson's disease, stomach ulcers, urination problems (thioxanthenes may worsen the condition), liver disease (higher blood levels of thioxanthenes may occur, increasing the likelihood of side effects), Reye's syndrome (the risk of liver problems may be increased), and seizure disorders (the risk of seizures may be increased).

Additional information about Truxal

Truxal Indication: For treatment of psychotic disorders (e.g. schizophrenia) and of acute mania occuring as part of bipolar disorders.
Mechanism Of Action: Truxal blocks postsynaptic mesolimbic dopaminergic D1 and D2 receptors in the brain; depresses the release of hypothalamic and hypophyseal hormones and is believed to depress the reticular activating system thus affecting basal metabolism, body temperature, wakefulness, vasomotor tone, and emesis.
Drug Interactions: Donepezil Possible antagonism of action
Galantamine Possible antagonism of action
Guanethidine The agent decreases the effect of guanethidine
Rivastigmine Possible antagonism of action
Food Interactions: Take with food to reduce irritation.
Avoid alcohol.
Generic Name: Chlorprothixene
Synonyms: Alpha-Chlorprothixene; Chloroprothixene; Chlorprothixen; Chlorprothixine; Chlorprotixen; Chlorprotixene; Chlorprotixine; Chlothixen; Cis-Chlorprothixene; CPT; CPX
Drug Category: Antipsychotics; Dopamine Antagonists
Drug Type: Small Molecule; Approved
Other Brand Names containing Chlorprothixene: Iaractan; Paxyl; Rentovet; Tactaran; Taractan; Tarasan; Tardan; Traquilan; Trictal; Truxal; Truxaletten; Truxil; Vetacalm;
Absorption: Incomplete bioavailability.
Toxicity (Overdose): Symptoms of overdose include difficulty in breathing (severe), dizziness (severe), drowsiness (severe), muscle trembling, jerking, stiffness, or uncontrolled movements (severe), small pupils, unusual excitement, and unusual tiredness or weakness (severe).
Protein Binding: Not Available
Biotransformation: Hepatic
Half Life: 8 to 12 hours
Dosage Forms of Truxal: Tablet Oral
Syrup Oral
Concentrate Oral
Solution Intramuscular
Chemical IUPAC Name: 3-(2-chlorothioxanthen-9-ylidene)-N,N-dimethylpropan-1-amine
Chemical Formula: C18H18ClNS
Chlorprothixene on Wikipedia: http://en.wikipedia.org/wiki/Chlorprothixene
Organisms Affected: Humans and other mammals

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