Flupenthixol + Melitracen
If previously the patient has been treated with tranquilizers with sedative effect these should be withdrawn gradually.
Depression, Anxiety, Apathy, Dysphoria
The immediate recovery phase after myocardial infarction, Defects in bundle-branch conduction, Untreated narrow angle glaucoma, Acute alcohol, barbiturate and opiate intoxications, Flupentixol-Melitracen should not be given to patients who have received a MAO-inhibitor within two weeks. Not recommended for excitable or overactive patients since its activating effect may lead to exaggeration of these characteristics.
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In the recommended doses side effects are rare. These could be transient restlessness and insomnia.
Flupentixol is a thioxanthene antipsychotic that inhibits dopamine-mediated effects by blocking postsynaptic dopamine receptors in the CNS. Melitracen is a TCA with anxiolytic properties.
May potentiate the adverse effects of drugs with antimuscarinic effects e.g. TCAs. Reduced efficacy of levodopa. Increases adverse extrapyramidal symptoms with dopamine antagonists (metoclopramide and prochlorperazine). Potentially Fatal: Potentiates CNS effects of alcohol, general anaesthetics, hypnotics, anxiolytics and opioids. Blocks antihypertensive effect of guanethidine. Additive toxicity with antimuscarinics, CNS depressants. Response to TCA may be accelerated with thyroid hormones; pressor effects of sympathomimetics may be enhanced; risk of serotonin syndrome when taken with other antidepressants. Antidiabetic dosage may need to be adjusted.
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Adults: Usually 2 tablets daily; morning and noon. In severe cases the morning dose may be increased to 2 tablets. Elderly: 1 tablet in the morning. Maintenance dose: Usually 1 tablet in the morning. In cases of insomnia or severe restlessness additional treatment with a sedative in the acute phase is recommended.
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