What is loxapine?

First generation ‘typical’ antipsychotics such as loxapine 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 loxapine?

Moderate quality evidence suggests loxapine results in greater improvement in global clinical state than placebo, but may result in more adverse effects. High quality evidence finds no differences in global effect, mental state or adverse effects between loxapine and other first generation antipsychotics. Moderate to high quality evidence finds no differences in global effect or mental state between loxapine and second generation antipsychotics, however loxapine may induce more extrapyramidal symptoms.

October 2020

Last updated at: 3:36 am, 14th October 2020
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