What is fluphenazine?

First generation ‘typical’ antipsychotics such as fluphenazine are an older class of antipsychotic than second generation ‘atypical’ antipsychotics. They are used primarily to treat positive symptoms including the experiences of perceptual abnormalities (hallucinations) and fixed, false, irrational beliefs (delusions). First generation antipsychotics may cause side effects which can differ depending on which antipsychotic is being administered and on individual differences in reaction to the drug. Reactions may include dyskinesias such as repetitive, involuntary, and purposeless body or facial movements, Parkinsonism (cogwheel muscle rigidity, pill-rolling tremor and reduced or slowed movements), akathisia (motor restlessness, especially in the legs, and resembling agitation) and dystonias such as muscle contractions causing unusual twisting of parts of the body, most often in the neck. These effects are caused by the dopamine receptor antagonist action of these drugs.

What is the evidence for fluphenazine?

Compared to placebo, moderate quality evidence suggests less risk of relapse with oral fluphenazine, however oral fluphenazine may result in drowsiness, akathisia and rigidity. Moderate to high quality evidence suggests no differences in acceptibility or response to treatment between oral fluphenazine and low-potency first generation antipsychotics. Moderate to low quality evidence suggests no differences in relapse rates between fluphenazine decanoate and first or second generation antipsychotics. There is less risk of movement disorders with fluphenazine decanoate than with pimozide or fluphenazine hydrochloride, but more risk of akathisia, dystonia, loss of associated movement, rigor, and tremor with oral fluphenazine than with low-potency first generation antipsychotics. There is greater risk of dizziness, drowsiness, sedation, dry mouth, nausea, and vomiting with low-potency first generation antipsychotics than with oral fluphenazine.

October 2020

Last updated at: 3:08 am, 14th October 2020
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Red - Topic summary has no current systematic review available.