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Psychotropic Use during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Thiothixene, a phenothiazine derivative, is a tranquilizer used to treat psychosis. Its chemical structure and pharmacological activity are similar to the piperazine phenothiazine compounds. First-trimester exposure to thiothixene was not associated with an increased frequency of congenital anomalies among 38 infants in one study (Rosa, 1993, unpublished). Birth defects were not increased in frequency in offspring of pregnant mice or rabbits given 20–180 times the usual human dose of thiothixene during embryogenesis (Owaki et al., 1969a, b).
Positron Emission Tomographic Studies on the Acute Effects of Psychoactive Drugs on Brain Metabolism and Mood
Published in Edythe D. London, Imaging Drug Action in the Brain, 2017
Edythe D. London, Michael J. Morgan
One study, however, has examined the effect of acute administration of a relatively selective dopamine antagonist, thiothixene. In a study of 4 schizophrenic patients and 12 normal subjects, acute administration of thiothixene in the schizophrenics tended to increase CMRglc in comparison to the effect in normal controls, although this effect achieved statistical significance only for the right basal ganglia (Volkow et al., 1986).
Neurobehavioral Syndromes in Patients with Cerebrovascular Pathology
Published in José León-Carrión, Margaret J. Giannini, Behavioral Neurology in the Elderly, 2001
María Dolores Jiménez, Eva Cuartero, Jorge Moreno
Psychotic symptoms (delirious ideas and hallucinations) have a high incidence in BD (they are present in 40% of the patients). The most frequent delirious contents are suspiciousness, oversensitivity to the environment, belief that there are strangers in the house, abandonment, grandeur, and infidelity. These symptoms increase the emotional burden of the caregivers, which usually leads to institutionalization of the patients. Other behavioral symptoms that hinder patient management even more include restlessness, agitation, hostility, urinary incontinence, and insomnia. Furthermore, the appearance of psychotic symptoms is related to a more rapid cognitive deterioration. Therefore, controlling all the above-mentioned problems is crucial for managing a patient with VaD. Neuroleptics can reduce aggressivity and agitation, which improves the patient’s standard of living and care. The minimum effective dosage should always be used to prevent the frequent undesirable effects (extrapyramidal alterations, somnolence, cognitive deterioration, and anticholinergic and paradoxical effects). There is no evidence that one neuroleptic drug is better than another. However, the efficacy of haloperidol, thioridazine, thiothixene, and loxapine has been demonstrated. More recently, low doses of modified neuroleptic drugs such as clozapine, olanzapine, and risperidone have allowed the control of psychotic symptoms with hardly any extrapyramidal or anticholinergic adverse effects.
Emerging 5-HT receptor antagonists for the treatment of Schizophrenia
Published in Expert Opinion on Emerging Drugs, 2020
Mackenzie T. Jones, Martin T. Strassnig, Philip D. Harvey
The history of drug development for the treatment of schizophrenia has often been based on chance findings rather than an in-depth understanding of the neurological basis of psychosis or the mechanism of action of these compounds. Conventional antipsychotics were identified as treatments for other conditions and developed first as therapeutic agents in the 1950 s, with antagonism of dopamine receptors found to be the primary mechanism of action. The high potency antipsychotic agents such as fluphenazine, pimozide, and haloperidol act primarily with the post-synaptic D2 receptor. They are effective at treating psychosis, however, the potent D2 blockade can also cause extrapyramidal symptoms. Conventional antipsychotics with lower D2 potency such as chlorpromazine, thiothixene, and trifluoperazine have reduced extrapyramidal side effects, but their increased activity at other receptor sites, such as the histaminergic and muscarinic acetylcholine receptor lead to other side effects. While this class of drugs has proven to be effective in the treatment of psychosis and disorganized thoughts, they do not offer a treatment for the negative symptoms of schizophrenia. Furthermore, the extrapyramidal side effects or sedation may lead to the appearance of secondary negative symptoms, which may be difficult to separate from the primary negative symptoms of the disease.
Fifty years of experience with loxapine for the rapid non-coercive tranquilization of acute behavioral disturbances in schizophrenia patients, and beyond
Published in Expert Review of Neurotherapeutics, 2022
Philippe Nuss, Emmanuelle Corruble, Emmanuelle Baloche, Ricardo P. Garay, Pierre-Michel Llorca
Dubin and Weiss [84] compared IM loxapine with IM thiothixene for rapid tranquilization of 58 acutely disturbed, psychotic patients (49 had schizophrenia and 9 had bipolar mania) (Table 4). The patients admitted through the ER were given intramuscular injections for 24 hours, followed by loxapine oral solution for 5 days in the psychiatric inpatient unit. Efficacy was assessed using ad hoc scales (BPRS and sedation scores). The median time to reach tranquilization was significantly less with loxapine (60 minutes) than with thiothixene (95 minutes; P = 0.001). At 1 hour, the percentage of patients reaching rapid tranquilization was significantly higher in the loxapine group (60% versus 14% in the thiothixene group; P < 0.001).
Dosing antipsychotics in special populations of patients with schizophrenia: severe psychotic agitation, first psychotic episode and elderly patients
Published in Expert Opinion on Pharmacotherapy, 2021
Fayçal Mouaffak, Florian Ferreri, Julie Bourgin-Duchesnay, Emmanuelle Baloche, Olivier Blin, Pierre Vandel, Ricardo P. Garay, Pierre Vidailhet, Emmanuelle Corruble, Pierre-Michel Llorca
3.2.5.1. IM loxapine. Two studies [48,49] reported that IM loxapine (25‒50 mg, 2–4 injections/day for 1‒3 days) was at least as sedating as haloperidol (2.5‒5 mg) (Table 2). A third study [50] showed that IM loxapine had at least similar efficacy as IM thiothixene for rapid tranquilization.