Side Effects of fluphenazine: A Synthesis of Findings from 22 Studies

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Original Abstract of the Article

Major Research Findings

Fluphenazine is an antipsychotic medication used to treat mental illnesses like schizophrenia. Several studies have shown that fluphenazine can cause side effects. These side effects can vary based on the method of administration, dosage, and individual patient factors. Some studies have investigated the potential of herbal remedies to mitigate the side effects of fluphenazine. For example, one study found that an extract from the plant Harpagophytum procumbens (EAF HP) effectively reduced fluphenazine-induced chewing movements in rats. This extract is promising for treating involuntary oral movements associated with fluphenazine. 18

Reasons for Side Effects

The side effects of fluphenazine are related to its action on dopamine receptors in the brain. Fluphenazine blocks dopamine receptors, which helps to alleviate symptoms of psychosis. However, dopamine is involved in many bodily functions, including movement, mood, and cognition. By interfering with dopamine signaling, fluphenazine can disrupt these functions and lead to various side effects.

Common Side Effects

Extrapyramidal Symptoms

Fluphenazine can cause extrapyramidal symptoms, which are movement disorders that include muscle stiffness, tremors, and difficulty initiating movements. 11 , 3 , 16 , 5 , 9 , 17 These symptoms are a direct result of fluphenazine's impact on dopamine receptors in the brain.

Tardive Dyskinesia

Long-term use of fluphenazine can lead to a serious movement disorder called tardive dyskinesia (TD). This involves involuntary movements, primarily of the face, tongue, and limbs. 18 , 21 , 11 , 14 , 6 It is thought that long-term exposure to fluphenazine may cause changes in dopamine receptor sensitivity, leading to TD.

Neuroleptic Malignant Syndrome

A potentially fatal side effect of fluphenazine is neuroleptic malignant syndrome (NMS). NMS is characterized by high fever, muscle rigidity, and changes in mental status. 13 NMS is a rare but serious complication of fluphenazine treatment, often linked to disruptions in the body's temperature regulation caused by the drug's effects on dopamine receptors.

Other Side Effects

In addition to the mentioned side effects, fluphenazine can also cause other adverse reactions. , 4 , , 2 , , 8 , 1 , 22 , 19 , 10 , , 7 , 12 , These may include weight gain, drowsiness, constipation, dry mouth, blurred vision, sexual dysfunction, and skin problems.

Countermeasures for Side Effects

Countermeasures for Extrapyramidal Symptoms

Extrapyramidal symptoms can often be managed with anticholinergic medications. 11 , 5 , 10 These medications work by blocking the action of acetylcholine in the brain, which can help to alleviate the movement problems. Lowering the fluphenazine dosage may also reduce extrapyramidal symptoms.

Countermeasures for Tardive Dyskinesia

If tardive dyskinesia develops, it may be possible to manage it by stopping fluphenazine or switching to a different antipsychotic medication. 21 However, TD can sometimes persist even after discontinuing fluphenazine.

Countermeasures for Neuroleptic Malignant Syndrome

Neuroleptic malignant syndrome is a medical emergency that requires immediate treatment. 13 Stopping fluphenazine and providing supportive care, such as managing fever and muscle rigidity, are essential steps in treating NMS.

Comparison between Studies

Commonalities among Studies

All studies on fluphenazine side effects agree that this medication has the potential to cause extrapyramidal symptoms, tardive dyskinesia, and neuroleptic malignant syndrome.

Differences among Studies

Studies on fluphenazine side effects show that several factors can influence the risk and severity of side effects. 18 For example, the method of administration (oral vs. injection), dosage, and individual patient factors, including age and underlying health conditions, all play a role.

Cautions Regarding Application in Real Life

It's important to be aware of the potential side effects of fluphenazine and discuss them openly with your doctor. 18 Close monitoring for any signs of side effects during treatment is crucial. Additionally, it's important to avoid driving or operating machinery while taking fluphenazine, as drowsiness is a possible side effect.

Limitations of Current Research

While there are many studies on fluphenazine, more research is needed, especially on the long-term effects of this medication. 18

Future Research Directions

Future research should focus on understanding the long-term side effects of fluphenazine, exploring ways to prevent and treat these side effects, and developing safer antipsychotic medications. 18

Conclusion

Fluphenazine is a valuable treatment option for certain mental health conditions, but it's important to be aware of its potential side effects. 18 Open communication with your doctor about your concerns and risks, as well as regular checkups, are essential for safe and effective treatment.

Literature analysis of 22 papers
Positive Content
12
Neutral Content
6
Negative Content
4
Article Type
3
1
1
2
19
1.

Plasma fluphenazine levels and clinical response in newly admitted schizophrenic patients.

Author: Van PuttenT, AravagiriM, MarderS R, WirshingW C, MintzJ, ChabertN

Improves psychosis
Disabling side effects

Higher plasma fluphenazine levels were associated with greater improvement in schizophrenia symptoms, but also with a higher rate of disabling side effects. Nearly 90% of patients experienced side effects that negated the therapeutic benefits. Fluphenazine N-oxide, a metabolite, was more strongly linked to side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

3.

[Extrapyramidal side effects of 2 different formulations of fluphenazine chloride injections].

Author: Milić-AskrabićJ, HadzovićS, SamardzićZ

Extrapyramidal side effects

This study compared the extrapyramidal side effects of two fluphenazine hydrochloride injections, Lyogen and Moditen, in mice. While both formulations caused similar catalepsy, Moditen exhibited a more intense cataleptic effect between 6-24 hours.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Croatian

4.

Extrapyramidal side effects caused by fluphenazine decanoate in a horse.

Author: KauffmanV G, SomaL, DiversT J, PerkonsS Z

sedation
agitation

Fluphenazine decanoate, a human antipsychotic drug, was given to a horse to provide long-term sedation. The horse became agitated and made repetitive motions, but sedation with barbiturates was effective treatment.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Double-blind comparison of haloperidol decanoate and fluphenazine decanoate effectiveness, side-effects, dosage and serum levels during a six months' treatment for relapse prevention.

Author: KisslingW, MöllerH J, WalterK, WittmannB, KruegerR, TrenkD

Reduced extrapyramidal symptoms
Relapse prevention
Psychotic relapse

Haloperidol decanoate and fluphenazine decanoate were equally effective in preventing relapse in schizophrenic patients. Haloperidol decanoate was associated with lower doses of anti-parkinson medication and fewer extrapyramidal symptoms.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

6.

Long-term depot maintenance of chronic schizophrenic out-patients: the seven year follow-up of the Medical Research Council fluphenazine/placebo trial. II. The incidence of compliance problems, side-effects, neurotic symptoms and depression.

Author: CursonD A, BarnesT R, BamberR W, PlattS D, HirschS R, DuffyJ C

Low Side Effect Prevalence
Schizophrenia Treatment
Depression
Non-Psychotic Symptoms

Depot neuroleptics were effective for maintaining 73% of patients for 7 years after the initial trial. Compliance was a major factor in relapses and hospital readmissions.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Comparative side effects of imipramine, benztropine, or their combination in patients receiving fluphenazine decanoate.

Author: SirisS G, RifkinA, ReardonG T, NovemberM

Exacerbated extrapyramidal side effects

Patients taking fluphenazine decanoate experienced increased extrapyramidal side effects when switching from benztropine to imipramine. However, adding imipramine to fluphenazine decanoate and benztropine did not significantly increase anticholinergic side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

8.

[Comparative investigation of action and side effects in intravenous, intramuscular and oral application of fluphenazine dihydrochloride (author's transl)].

Author: MaurerY A

The effects and side effects of fluphenazine dihydrochloride were investigated in 51 acutely diseased schizophrenics via intravenous, intramuscular, and oral routes. The assessment of efficacy, painfulness, and repeated selection of the form of application was also recorded.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : German

9.

Comparison of the incidence and severity of extrapyramidal side effects with fluphenazine enanthate and fluphenazine decanoate.

Author: KaneJ, QuitkinF, RifkinA, KleinD F

Extrapyramidal symptoms

Fluphenazine enanthate and fluphenazine decanoate were both effective in treating schizophrenia, but fluphenazine enanthate was associated with more extrapyramidal side effects, particularly akathisia.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

10.

A comparative trial of orphenadrine and tofenacin in the control of depression and extrapyramidal side-effects associated with fluphenazine decanoate therapy.

Author: CapstickN, PudneyH

Depression control
Parkinsonism control

Both orphenadrine hydrochloride and its metabolite, tofenacin hydrochloride, effectively controlled Parkinsonian side effects in patients receiving fluphenazine decanoate. However, orphenadrine was significantly better (p < 0.05) at controlling depressive side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

11.

Benzhexol and side effects with long-acting fluphenazine therapy.

Author: GroveL, CrammerJ L

Reduced extra-pyramidal signs
Severe reactions

In a study of 16 patients with extrapyramidal symptoms from fluphenazine enanthate, 4 out of 8 patients experienced severe reactions when benzhexol was withdrawn, while the other 4 did not. This suggests that while acute withdrawal is unnecessary, occasional dose adjustment of anti-Parkinsonian drugs is advisable.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

14.

Current Management of Tics and Tourette Syndrome: Behavioral, Pharmacologic, and Surgical Treatments.

Author: BillnitzerAndrew, JankovicJoseph

Tic control
Metabolic syndrome
Tardive dyskinesia

Tourette syndrome, a neurobehavioral disorder characterized by tics, often requires a multidisciplinary approach to treatment. This review provides an overview of treatment options, including behavioral therapy, pharmacological therapies, and experimental therapies such as deep brain stimulation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

15.

Drug-Drug-Induced Akathisia: Two Case Reports.

Author: Owusu AboagyeGrace, AnkrahDaniel

Akathisia treatment

Drug-drug interactions between psychotropic medications and antimicrobials can lead to akathisia, an extrapyramidal side effect. This report highlights the importance of considering drug interactions as a potential cause of extrapyramidal side effects.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

17.

Long-acting formulation leading to severe long-term adverse effects: a case report of fluphenazine and persistent extrapyramidal symptoms.

Author: OmiT, MitsuiY, MatsunagaH

Improved symptoms
Severe side effects

Long-acting formulations of fluphenazine decanoate may lead to severe persistent extrapyramidal symptoms. Antiparkinsonian drug therapy with bromocriptine may be a possible option for preventing fluphenazine-induced side effects.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

18.

Harpagophytum Procumbens Ethyl Acetate Fraction Reduces Fluphenazine-Induced Vacuous Chewing Movements and Oxidative Stress in Rat Brain.

Author: SchafferLarissa Finger, de FreitasCatiuscia Molz, Chiapinotto CerettaAna Paula, PerozaLuis Ricardo, de Moraes ReisElizete, KrumBárbara Nunes, BusanelloAlcindo, BoligonAline Augusti, SudatiJéssie Haigert, FachinettoRoselei, WagnerCaroline

Reduced oral movements

Harpagophytum procumbens, an herbal medicine, may be a promising treatment for fluphenazine-induced orofacial dyskinesia, a side effect of long-term antipsychotic treatment. In a study of rats, H. procumbens was shown to reduce the number of vacuous chewing movements, a key symptom of orofacial dyskinesia. It also reduced oxidative damage in the cortex and striatum, areas of the brain affected by fluphenazine.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

Cytotoxicity of phenothiazine derivatives associated with mitochondrial dysfunction: a structure-activity investigation.

Author: de FariaPriscila A, BettaninFernanda, CunhaRodrigo L O R, Paredes-GameroEdgar J, Homem-de-MelloPaula, NantesIseli L, RodriguesTiago

Cytotoxic activity
Hepatotoxicity

This study investigated the effects of five phenothiazine derivatives on the viability of liver cells. All derivatives were found to be toxic to cells, with thioridazine exhibiting the highest toxicity. The findings suggest that the mitochondrial permeability transition may be involved in phenothiazine-induced cell death.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

20.

Fluphenazine versus low-potency first-generation antipsychotic drugs for schizophrenia.

Author: TardyMagdolna, HuhnMaximilian, EngelRolf R, LeuchtStefan

Side effects

This review examined the effects of the high-potency antipsychotic fluphenazine compared to low-potency antipsychotics in schizophrenia treatment. Despite treatment guidelines stating no difference in efficacy between antipsychotic compounds, clinicians often perceive low-potency antipsychotics as less efficacious. The review found that fluphenazine was as effective as low-potency antipsychotics in controlling positive symptoms, but may be associated with a higher risk of extrapyramidal side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

22.

Ten year outcomes of outpatients with schizophrenia on conventional depot antipsychotics: a systematic chart review.

Author: UchidaTakahito, SuzukiTakefumi, SakuraiHitoshi, TsutsumiChisa, DenRyosuke, MimuraMasaru, UchidaHiroyuki

Relapse

This study found that 18.9% of patients with schizophrenia maintained outpatient status for 10 years while receiving depot antipsychotics. The most frequent reason for dropout was hospitalization.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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