What is zuclopenthixol?

First generation ‘typical’ antipsychotics such as zuclopenthixol 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 zuclopenthixol?

Moderate to low quality evidence found no difference in study retention compared with placebo. There were fewer injections required with zuclopenthixol acetate than with first generation antipsychotic haloperidol, but no differences in the number of supplementary antipsychotics. Higher quality evidence found more people left the study early for any reason with zuclopenthixol compared to first generation antipsychotic chlorpromazine. Moderate to low quality evidence found more extrapyramidal symptoms with zuclopenthixol than with first generation antipsychotic perphenazine.

Compared to second generation antipsychotic risperidone, moderate quality evidence found no differences in mental state or study retention. Moderate to low quality evidence found zuclopenthixol was associated with more parkinsonian symptoms than risperidone.

October 2020

Last updated at: 4:15 am, 14th October 2020
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