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Thiothixene Disease Interactions

There are 22 disease interactions with thiothixene:

Major

Atypical Antipsychotic Agents (Includes Thiothixene) ↔ Dementia

Severe Potential Hazard, High plausibility

Applies to: Dementia

Elderly patients with dementia- related psychosis treated with antipsychotic drugs are at an increased risk of death, mostly from cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) causes. A causal relationship with antipsychotic use has not been established. In controlled trials, treatment with some atypical antipsychotic drugs was also associated with an increased risk of cerebrovascular adverse events (e.g., stroke, transient ischemic attack), including fatalities, in elderly patients with dementia- related psychosis. These agents are not approved for the treatment of patients with dementia- related psychosis.

Major

Neuroleptics (Includes Thiothixene) ↔ Acute Alcohol Intoxication

Severe Potential Hazard, High plausibility

Applies to: Alcoholism

The use of neuroleptic agents is contraindicated in patients with acute alcohol intoxication exhibiting depressed vital signs. The central nervous system depressant effects of neuroleptic agents may be additive with those of alcohol. Severe respiratory depression and respiratory arrest may occur. Therapy with neuroleptic agents should be administered cautiously in patients who might be prone to acute alcohol intake.

References

  1. "Product Information. Geodon (ziprasidone)." Pfizer US Pharmaceuticals, New York, NY.
  2. "Product Information. Risperdal (risperidone)." Janssen Pharmaceutica, Titusville, NJ.
  3. "Product Information. Orap Tablets (pimozide)." Gate Pharmaceuticals, Sellersville, PA.
  4. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company, Indianapolis, IN.
  5. "Product Information. Navane (thiothixene)." Roerig Division, New York, NY.
  6. "Product Information. Moban (molindone)." Gate Pharmaceuticals, Sellersville, PA.
  7. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals, East Hanover, NJ.
  8. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical, Raritan, NJ.
  9. "Product Information. Seroquel (quetiapine)." Zeneca Pharmaceuticals, Wilmington, DE.
  10. "Product Information. Loxitane C Oral Concentrate (loxapine)" Watson Laboratories Inc, Corona, CA.
View all 10 references
Major

Neuroleptics (Includes Thiothixene) ↔ Cardiovascular Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Hypotension, Cerebrovascular Insufficiency, History - Myocardial Infarction, History - Cerebrovascular Disease, Heart Disease

Neuroleptic agents may cause hypotension (including orthostatic hypotension), reflex tachycardia, increased pulse rate, syncope and dizziness, particularly during initiation of therapy or rapid escalation of dosage. Tolerance to the hypotensive effects often develops after a few doses to a few weeks. Rarely, fatal cardiac arrest has occurred secondary to severe hypotension. Other reported adverse cardiovascular effects include hypertension, edema, arrhythmias, thrombophlebitis, myocarditis, angina, myocardial infarction, congestive heart failure, and ECG abnormalities such as PR and QT interval prolongation, diffuse T-wave flattening, and ST segment depression. Therapy with neuroleptic agents should be administered cautiously in patients with severe cardiovascular disease, pheochromocytoma, a predisposition to hypotension, or conditions that could be exacerbated by hypotension such as a history of myocardial infarction, angina, or ischemic stroke. Close monitoring of cardiovascular status, including ECG changes, is recommended at all dosages. If parenteral therapy is given, patients should be in a supine position during administration and for at least 30 to 60 minutes afterwards. Patients who experience orthostatic hypotension should be cautioned not to rise too abruptly. Occasionally, when severe, hypotension may require treatment with vasoconstrictive agents such as norepinephrine or phenylephrine. Epinephrine should not be used, however, since neuroleptic agents can reverse its vasopressor effects and cause a further lowering of blood pressure.

References

  1. "Product Information. Risperdal (risperidone)." Janssen Pharmaceutica, Titusville, NJ.
  2. Centorrino F, Baldessarini RJ, Kando JC, Frankenburg FR, Volpicelli SA, Flood JG "Clozapine and metabolites - concentrations in serum and clinical findings during treatment of chronically psychotic patients." J Clin Psychopharmacol 14 (1994): 119-25
  3. Gupta S "Paradoxical hypertension associated with clozapine." Am J Psychiatry 151 (1994): 148
  4. Tueth M "Side effects of clozipine (Clozaril) requiring emergency treatment." Am J Emerg Med 11 (1993): 312-3
  5. "Product Information. Moban (molindone)." Gate Pharmaceuticals, Sellersville, PA.
  6. "Product Information. Navane (thiothixene)." Roerig Division, New York, NY.
  7. O'Brien JM, Rockwood RP, Suh KI "Haloperidol-induced torsade de pointes." Ann Pharmacother 33 (1999): 1046-9
  8. McCance-Katz EF "New onset Raynaud's phenomenon in a schizophrenic patient ." J Clin Psychiatry 52 (1991): 89-90
  9. DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM "Pharmacotherapy: A Pathophysiologic Approach 4th" Stamford, CT: Appleton & Lange (1999):
  10. La Grenade L, Graham D, Trontell A "Myocarditis and cardiomyopathy associated with clozapine use in the United States." N Engl J Med 345 (2001): 224-5
  11. Hatta K, Takahashi T, Nakamura H, Yamashiro H, Asukai N, Matsuzaki I, Yonezawa Y "The association between intravenous haloperidol and prolonged QT interval." J Clin Psychopharmacol 21 (2001): 257-61
  12. Ravin DS, Levenson JW "Fatal cardiac event following initiation of risperidone therapy." Ann Pharmacother 31 (1997): 867-70
  13. Testani M "Clozapine-induced orthostatic hypotension treated with fludrocortisone." J Clin Psychiatry 55 (1994): 497-8
  14. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical, Raritan, NJ.
  15. Kerwin R "Adverse reaction reporting and new antipsychotics." Lancet 342 (1993): 1440
  16. Lieberman JA, Safferman AZ "Clinical profile of clozapine: adverse reactions and agranulocytosis." Psychiatr Q 63 (1992): 51-70
  17. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals, East Hanover, NJ.
  18. Metzger E, Friedman R "Prolongation of the corrected QT and torsades de pointes cardiac arrhythmia associated with intravenous haloperidol in the medically ill." J Clin Psychopharmacol 13 (1993): 128-32
  19. "Product Information. Seroquel (quetiapine)." Zeneca Pharmaceuticals, Wilmington, DE.
  20. "Product Information. Loxitane C Oral Concentrate (loxapine)" Watson Laboratories Inc, Corona, CA.
  21. Wilt JL, Minnema AM, Johnson RF, Rosenblum AM "Torsade de pointes associated with the use of intravenous haloperidol." Ann Intern Med 119 (1993): 391-4
  22. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company, Indianapolis, IN.
  23. Marinkovic D, Timotijevic I, Babinski T, Totic S, Paunovic VR "The side-effects of clozapine: a four year follow-up study." Prog Neuropsychopharmacol Biol Psychiatry 18 (1994): 537-44
  24. "Product Information. Geodon (ziprasidone)." Pfizer US Pharmaceuticals, New York, NY.
  25. Aronowitz JS, Umbricht DSG, Safferman AZ "Clozapine and new-onset ECG abnormalities." Psychosomatics 36 (1995): 82-3
  26. Heel RC, Brogden RN, Speight TM, Avery GS "Loxapine: a review of its pharmacological properties and therapeutic efficacy as an antipsychotic agent." Drugs 15 (1978): 198-217
  27. Huyse F, van Schijndel RS "Haloperidol and cardiac arrest." Lancet 2 (1988): 568-9
  28. Baldassano CF, Ghaemi SN "Generalized edema with risperidone: divalproex sodium treatment." J Clin Psychiatry 57 (1996): 422
View all 28 references
Major

Neuroleptics (Includes Thiothixene) ↔ Cns Depression

Severe Potential Hazard, High plausibility

Applies to: Altered Consciousness, Respiratory Arrest

The use of neuroleptic agents is contraindicated in comatose patients and patients with severe central nervous system depression. Neuroleptic agents may potentiate the CNS and respiratory depression in these patients.

References

  1. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical, Raritan, NJ.
  2. "Product Information. Moban (molindone)." Gate Pharmaceuticals, Sellersville, PA.
  3. "Product Information. Navane (thiothixene)." Roerig Division, New York, NY.
  4. Vetter PH, Proppe DG "Clozapine-induced coma." J Nerv Ment Dis 180 (1992): 58-9
  5. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals, East Hanover, NJ.
  6. "Product Information. Loxitane C Oral Concentrate (loxapine)" Watson Laboratories Inc, Corona, CA.
  7. "Product Information. Orap Tablets (pimozide)." Gate Pharmaceuticals, Sellersville, PA.
View all 7 references
Major

Neuroleptics (Includes Thiothixene) ↔ Nms

Severe Potential Hazard, High plausibility

Applies to: Neuroleptic Malignant Syndrome

The central dopaminergic blocking effects of neuroleptic agents may precipitate or aggravate a potentially fatal symptom complex known as neuroleptic malignant syndrome (NMS). NMS is observed most frequently when high-potency agents like haloperidol are administered intramuscularly, but may occur with any neuroleptic agent given for any length of time. Clinical manifestations of NMS include hyperpyrexia, muscle rigidity, altered mental status and autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis and cardiac arrhythmias). Additional signs may include elevated creatine phosphokinase, myoglobinuria, and acute renal failure. Neuroleptic agents should not be given to patients with active NMS and should be immediately discontinued if currently being administered in such patients. In patients with a history of NMS, introduction or reintroduction of neuroleptic agents should be carefully considered, since NMS may recur.

References

  1. Anderson ES, Powers PS "Neuroleptic malignant syndrome associated with clozapine use." J Clin Psychiatry 52 (1991): 102-4
  2. Sharma R, Trappler B, Ng YK, Leeman CP "Risperidone-induced neutroleptic malignant syndrome." Ann Pharmacother 30 (1996): 775-8
  3. Campellone JV, Mccluskey LF, Greenspan D "Fatal outcome from neuroleptic malignant syndrome associated with clozapine." Neuropsychiatry Neuropsychol Behav Neurol 8 (1995): 70-3
  4. Johnson V, Bruxner G "Neuroleptic malignant syndrome associated with olanzapine." Aust N Z J Psychiat 32 (1998): 884-6
  5. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical, Raritan, NJ.
  6. Margolese HC, Chouinard G "Olanzapine-induced neuroleptic malignant syndrome with mental retardation." Am J Psychiat 156 (1999): 1115-6
  7. SierraBiddle D, Herran A, DiezAja S, GonzalezMata JM, Vidal E, DiezManrique F, VazquezBarquero JL "Neuroleptic malignant syndrome and olanzapine." J Clin Psychopharmacol 20 (2000): 704-5
  8. Tarsy D "Risperidone and neuroleptic malignant syndrome." JAMA 275 (1996): 446
  9. Miller DD, Sharafuddin MJ, Kathol RG "A case of clozapine-induced neuroleptic malignant syndrome." J Clin Psychiatry 52 (1991): 99-101
  10. Levenson JL "Neuroleptic malignant syndrome after the initiation of olanzapine." J Clin Psychopharmacol 19 (1999): 477-8
  11. Dave M "Two cases of risperidone-induced neuroleptic malignant syndrome." Am J Psychiatry 152 (1995): 1233-4
  12. "Product Information. Seroquel (quetiapine)." Zeneca Pharmaceuticals, Wilmington, DE.
  13. Chong LS, Abbott PM "Neuroleptic malignant syndrome secondary to loxapine." Br J Psychiatry 159 (1991): 572-3
  14. Hermesh H, Sirota P, Eviatar J "Recurrent neuroleptic malignant syndrome due to haloperidol and amantadine." Biol Psychiatry 25 (1989): 962-5
  15. Burkhard PR, Vingerhoets FJG "Olanzapine induced neuroleptic malignant syndrome." Arch Gen Psychiat 56 (1999): 101-2
  16. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals, East Hanover, NJ.
  17. Najara JE, Enikeev ID "Risperidone and neuroleptic malignant syndrome: a case report." J Clin Psychiatry 56 (1995): 534-5
  18. Nemecek D "Atropism may precipitate neuroleptic malignant syndrome during treatment with clozapine." Am J Psychiatry 150 (1993): 1561
  19. Aisen PS, Lawlor BA "Neuroleptic malignant syndrome induced by low-dose haloperidol." Am J Psychiatry 149 (1992): 844
  20. Singer S, Richards C, Boland RJ "Two cases of risperidone-induced neuroleptic malignant syndrome." Am J Psychiatry 152 (1995): 1234
  21. Nyfort-Hansen K, Alderman CP "Possible neuroleptic malignant syndrome associated with olanzapine." Ann Pharmacother 34 (2000): 667
  22. "Product Information. Risperdal (risperidone)." Janssen Pharmaceutica, Titusville, NJ.
  23. "Product Information. Geodon (ziprasidone)." Pfizer US Pharmaceuticals, New York, NY.
  24. "Product Information. Abilify (aripiprazole)." Bristol-Myers Squibb, Princeton, NJ.
  25. Padgett R, Lipman E "Use of neuroleptics after an episode of neuroleptic malignant syndrome" Can J Psychiatry 34 (1989): 323-5
  26. Caroff SN "The neuroleptic malignant syndrome." J Clin Psychiatry 41 (1980): 79-83
  27. "Product Information. Loxitane C Oral Concentrate (loxapine)" Watson Laboratories Inc, Corona, CA.
  28. Raitasuo V, Vataja R, Elomaa E "Risperidone-induced neuroleptic malignant syndrome in young patient." Lancet 344 (1994): 1705
  29. "Product Information. Moban (molindone)." Gate Pharmaceuticals, Sellersville, PA.
  30. Ryken TC, Merrell AN "Haloperidol-induced neuroleptic malignant syndrome in a 67-year-old woman with parkinsonism." West J Med 151 (1989): 326-8
  31. Kern JL, Cernek PK "Delayed risperidone-induced malignant syndrome." Ann Pharmacother 30 (1996): 300
  32. Moltz DA, Coeytaux RR "Case report: Possible neuroleptic malignant syndrome associated with olanzapine." J Clin Psychopharmacol 18 (1998): 485-6
  33. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company, Indianapolis, IN.
  34. "Product Information. Orap Tablets (pimozide)." Gate Pharmaceuticals, Sellersville, PA.
  35. Ewert AL, Kloek J, Wells B, Phelps S "Neuroleptic malignant syndrome associated with loxapine" J Clin Psychiatry 44 (1983): 37-8
  36. Webster P, Wijeratne C "Risperidone-induced neuroleptic malignant syndrome." Lancet 344 (1994): 1228-9
  37. Levitt AJ, Midha R, Craven JL "Neuroleptic malignant syndrome with intravenous haloperidol." Can J Psychiatry 35 (1990): 789
  38. Gleason PP, Conigliaro RL "Neuroleptic malignant syndrome with risperidone." Pharmacotherapy 17 (1997): 617-21
  39. "Product Information. Navane (thiothixene)." Roerig Division, New York, NY.
  40. DasGupta K, Young A "Clozapine-induced neuroleptic malignant syndrome." J Clin Psychiatry 52 (1991): 105-7
View all 40 references
Major

Neuroleptics (Includes Thiothixene) ↔ Tardive Dyskinesia

Severe Potential Hazard, High plausibility

Applies to: Tardive Dyskinesia

Neuroleptic agents may precipitate symptoms of tardive dyskinesia (TD), a syndrome consisting of rhythmic involuntary movements variously involving the tongue, face, mouth, lips, jaw, and/or trunk and extremities, following chronic use of at least several months but often years. Elderly patients, particularly women, are most susceptible. Both the risk of developing the syndrome and the likelihood that it will become irreversible increase with the duration and total cumulative dose of neuroleptic therapy administered. However, patients may infrequently develop symptoms after relatively brief treatment periods at low dosages. If TD occurs during neuroleptic therapy, prompt withdrawal of the offending agent or at least a lowering of the dosage should be considered. TD symptoms may become more severe after drug discontinuation or a dosage reduction, but may gradually improve over months to years. In patients with preexisting drug-induced TD, initiating or increasing the dosage of neuroleptic therapy may temporarily mask the symptoms of TD but could eventually worsen the condition. The newer, atypical neuroleptic agents (e.g., risperidone, quetiapine, olanzapine) tend to be associated with a substantially reduced risk of inducing TD and are considered the drugs of choice in patients being treated for psychosis.

References

  1. Yesavage JA, Tanke ED, Sheikh JI "Tardive dyskinesia and steady-state serum levels of thiothixene." Arch Gen Psychiatry 44 (1987): 913-5
  2. Kopala LC, Honer WG "Schizophrenia and severe tardive dyskinesia responsive to risperidone." J Clin Psychopharmacol 14 (1994): 430-1
  3. Pinder RM, Brogden RN, Swayer R, Speight TM, Spencer R, Avery GS "Pimozide: a review of its pharmacological properties and therapeutic uses in psychiatry." Drugs 12 (1976): 1-40
  4. "Product Information. Abilify (aripiprazole)." Bristol-Myers Squibb, Princeton, NJ.
  5. Ghelber D, Belmaker RH "Tardive dyskinesia with quetiapine." Am J Psychiat 156 (1999): 796-7
  6. "Product Information. Risperdal (risperidone)." Janssen Pharmaceutica, Titusville, NJ.
  7. Buzan RD "Risperidone-induced tardive dyskinesia." Am J Psychiatry 153 (1996): 734-5
  8. Little JT, Jankovic J "Tardive myoclonus." Mov Disord 2 (1987): 307-11
  9. "Product Information. Orap Tablets (pimozide)." Gate Pharmaceuticals, Sellersville, PA.
  10. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company, Indianapolis, IN.
  11. Dave M "Clozapine-related tardive dyskinesia." Biol Psychiatry 35 (1994): 886-7
  12. Tamminga CA, Thaker GK, Moran M, Kakigi T, Gao XM "Clozapine in tardive dyskinesia - observations from human and animal model studies." J Clin Psychiatry 55 (1994): 102-6
  13. "Product Information. Moban (molindone)." Gate Pharmaceuticals, Sellersville, PA.
  14. Yassa R, Mohelsky HE "Tardive dyskinesia in thiothixene treatment ." J Clin Psychiatry 46 (1985): 151
  15. "Product Information. Navane (thiothixene)." Roerig Division, New York, NY.
  16. Bruun RD "Subtle and underrecognized side effects of neuroleptic treatment in children with Tourette's disorder." Am J Psychiatry 145 (1988): 621-4
  17. Branchey MH, Branchey LB, Richardson MA "Effects of neuroleptic adjustment on clinical condition and tardive dyskinesia in schizophrenic patients." Am J Psychiatry 138 (1981): 608-12
  18. de Leon J, Moral L, Camunas C "Clozapine and jaw dyskinesia: a case report." J Clin Psychiatry 52 (1991): 494-5
  19. "Product Information. Geodon (ziprasidone)." Pfizer US Pharmaceuticals, New York, NY.
  20. Pakkenberg H, Fog R "Spontaneous oral dyskinesia. Results of treatment with tetrabenazine, pimozide, or both." Arch Neurol 31 (1974): 352-3
  21. Portnoy RA "Hyperkinetic dysarthria as an early indicator of impending tardive dyskinesia." J Speech Hear Disord 44 (1979): 214-9
  22. Gwinn KA, Caviness JN "Risperidone-induced tardive dyskinesia and parkinsonism." Mov Disord 12 (1997): 119-21
  23. Meltzer HY, Luchins DJ "Effect of clozapine in severe tardive dyskinesia: a case report." J Clin Psychopharmacol 4 (1984): 286-7
  24. Mahmood T, Clothier EB, Bridgman R "Risperidone-induced extrapyramidal reactions." Lancet 346 (1995): 1226
  25. Herran A, Vazquez-Barquero JL "Tardive dyskinesia associated with olanzapine." Ann Intern Med 131 (1999): 72
  26. Bransgrove LL, Kelly MW "Movement disorders in patients treated with long-acting injectable antipsychotic drugs." Am J Hosp Pharm 51 (1994): 895-9
  27. Elliott ES, Marken PA, Ruehter VL "Clozapine-associated extrapyramidal reaction." Ann Pharmacother 34 (2000): 615-8
  28. Woerner MG, Sheitman BB, Lieberman JA, Kane JM "Tardive dyskinesia induced by risperidone?" Am J Psychiatry 153 (1996): 843
  29. Owens DGC "Extrapyramidal side effects and tolerability of risperidone - a review." J Clin Psychiatry 55 Suppl (1994): 29-35
  30. Friedman JH "Clozapine treatment of psychosis in patients with tardive dystonia: report of three cases." Mov Disord 9 (1994): 321-4
  31. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical, Raritan, NJ.
  32. Peabody CA, Brody D, Warner MD "Tardive dyskinesia after low-dose haloperidol." Biol Psychiatry 22 (1987): 111-2
  33. Narendran R, Young CM, Pato MT "Possible risperidone-induced tardive dystonia." Ann Pharmacother 34 (2000): 1487-8
  34. "Product Information. Loxitane C Oral Concentrate (loxapine)" Watson Laboratories Inc, Corona, CA.
  35. Riddle MA, Hardin MT, Towbin KE, et al "Tardive dyskinesia following haloperidol treatment in Tourette's syndrome." Arch Gen Psychiatry 44 (1987): 98-9
  36. Small JG, Milstein V, Marhenke JD, Hall DD, Kellams JJ "Treatment outcome with clozapine in tardive dyskinesia, neuroleptic sensitivity, and treatment-resistant psychosis." J Clin Psychiatry 48 (1987): 263-7
  37. Lamberti JS, Bellnier T "Clozapine and tardive dystonia." J Nerv Ment Dis 181 (1993): 137-8
  38. DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM "Pharmacotherapy: A Pathophysiologic Approach 4th" Stamford, CT: Appleton & Lange (1999):
  39. "Product Information. Seroquel (quetiapine)." Zeneca Pharmaceuticals, Wilmington, DE.
  40. Dave M "Tardive oculogyric crises with clozapine." J Clin Psychiatry 55 (1994): 264-5
  41. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals, East Hanover, NJ.
  42. Heel RC, Brogden RN, Speight TM, Avery GS "Loxapine: a review of its pharmacological properties and therapeutic efficacy as an antipsychotic agent." Drugs 15 (1978): 198-217
View all 42 references
Major

Thiothixene (Includes Thiothixene) ↔ Cns Depression

Severe Potential Hazard, Moderate plausibility

Applies to: Altered Consciousness

The use of thiothixene is contraindicated in comatose patients and patients with severe central nervous system depression. Thiothixene may potentiate the CNS and respiratory depression in these patients.

Major

Thiothixene (Includes Thiothixene) ↔ Hematologic Toxicity

Severe Potential Hazard, High plausibility

Applies to: Bone Marrow Depression/Low Blood Counts

The use of phenothiazines has been associated with hematologic toxicity, including agranulocytosis, thrombocytopenia, eosinophilia, aplastic anemia, purpura, granulocytopenia, and hemolytic anemia. Mild leukopenia has occurred frequently with large doses over prolonged periods but has generally been reversible despite continued treatment. Since thiothixene is structurally related to the piperazine phenothiazines, the manufacturers recommend that it not be used in patients with preexisting blood dyscrasias. Leukopenia and leukocytosis, which are usually transient, have been reported with the use of thiothixene.

References

  1. Holt RJ "Fluphenazine decanoate-induced cholestatic jaundice and thrombocytopenia." Pharmacotherapy 4 (1984): 227-9
  2. Aram H "Henoch-Schonlein purpura induced by chlorpromazine." J Am Acad Dermatol 17 (1987): 139-40
  3. Young A, Kehoe R "Two cases of agranulocytosis on addition of a butyrophenone to a long-standing course of phenothiazine treatment." Br J Psychiatry 154 (1989): 710-12
  4. "Product Information. Navane (thiothixene)." Roerig Division, New York, NY.
  5. Balon R, Berchou R, Zethelius M "Thrombocytopenia associated with chlorpromazine, haloperidol and thiothixene: a case report." Can J Psychiatry 32 (1987): 149-50
  6. Rosenthal DS, Stein GF, Santos JC "Thioridazine agranulocytosis." JAMA 200 (1967): 81-2
  7. Yassa R "Agranulocytosis in the course of phenothiazine therapy." J Clin Psychiatry 46 (1985): 341-3
  8. Stein P, Inwood M "Hemolytic anemia associated with chlorpromazine therapy." Can J Psychiatry 25 (1980): 659-61
  9. Holt R "Neuroleptic drug-induced changes in platelet levels." J Clin Psychopharmacol 4 (1984): 130-2
  10. Zengotita H, Holt R "Neuroleptic drug-induced coagulopathy: mechanism of reaction and duration of effect." J Clin Psychiatry 47 (1986): 35-7
  11. Ben-Yehuda A, Bloom A, Lijhovetzky G, et al "Chlorpromazine-induced liver and bone marrow granulomas associated with agranulocytosis." Isr J Med Sci 26 (1990): 449-51
View all 11 references
Moderate

Antipsychotic/Neuroleptic Agents (Includes Thiothixene) ↔ Seizure

Moderate Potential Hazard, Moderate plausibility

Applies to: Alcoholism, Seizures, Head Injury

Antipsychotic and neuroleptic drugs can lower the seizure threshold and trigger seizures in a dose-dependent manner. This risk is greatest in patients with a history of seizures or with conditions that lower the seizure threshold. Therapy with these drugs should be administered cautiously in patients with a history of seizures or other predisposing factors, such as head trauma, CNS abnormalities, and alcoholism.

Moderate

Neuroleptics (Includes Thiothixene) ↔ Anticholinergic Effects

Moderate Potential Hazard, Moderate plausibility

Applies to: Gastrointestinal Obstruction, Glaucoma/Intraocular Hypertension, Urinary Retention

Most neuroleptic agents have anticholinergic activity, to which elderly patients are particularly sensitive. Clozapine and low- potency agents such as chlorpromazine and thioridazine tend to exhibit the greatest degree of anticholinergic effects in the class, while haloperidol as well as the newer, atypical agents like quetiapine, risperidone and ziprasidone have generally been associated with very low frequencies of anticholinergic adverse effects. Therapy with neuroleptic agents should be administered cautiously in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders.

References

  1. Frankenburg FR, Kando JC, Centorrino F, Gilbert JM "Bladder dysfunction associated with clozapine therapy." J Clin Psychiatry 57 (1996): 39-40
  2. "Product Information. Moban (molindone)." Gate Pharmaceuticals, Sellersville, PA.
  3. Grohmann R, Ruther E, Sassim N, Schmidt LG "Adverse effects of clozapine." Psychopharmacology (Berl) 99 (1989): s101-4
  4. Cohen MAA, Alfonso CA, Mosquera M "Development of urinary retention during treatment with clozapine and meclizine." Am J Psychiatry 151 (1994): 619-20
  5. "Product Information. Navane (thiothixene)." Roerig Division, New York, NY.
  6. Heel RC, Brogden RN, Speight TM, Avery GS "Loxapine: a review of its pharmacological properties and therapeutic efficacy as an antipsychotic agent." Drugs 15 (1978): 198-217
  7. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals, East Hanover, NJ.
  8. "Product Information. Loxitane C Oral Concentrate (loxapine)" Watson Laboratories Inc, Corona, CA.
  9. DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM "Pharmacotherapy: A Pathophysiologic Approach 4th" Stamford, CT: Appleton & Lange (1999):
  10. Marinkovic D, Timotijevic I, Babinski T, Totic S, Paunovic VR "The side-effects of clozapine: a four year follow-up study." Prog Neuropsychopharmacol Biol Psychiatry 18 (1994): 537-44
  11. "Product Information. Orap Tablets (pimozide)." Gate Pharmaceuticals, Sellersville, PA.
  12. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company, Indianapolis, IN.
  13. Tueth M "Side effects of clozipine (Clozaril) requiring emergency treatment." Am J Emerg Med 11 (1993): 312-3
  14. Pinder RM, Brogden RN, Swayer R, Speight TM, Spencer R, Avery GS "Pimozide: a review of its pharmacological properties and therapeutic uses in psychiatry." Drugs 12 (1976): 1-40
View all 14 references
Moderate

Neuroleptics (Includes Thiothixene) ↔ Dehydration

Moderate Potential Hazard, Moderate plausibility

Applies to: Dehydration, Diarrhea, Vomiting

Neuroleptic agents may cause hypotension (including orthostatic hypotension) and associated reflex tachycardia, syncope or dizziness, particularly during initiation of therapy or rapid escalation of dosage. Tolerance to the hypotensive effects often develops after a few doses to a few months. Rarely, fatal cardiac arrest has occurred secondary to severe hypotension. Therapy with neuroleptic agents should be administered cautiously in patients with conditions that would predispose them to hypotension, such as hypovolemia or dehydration (e.g., due to severe diarrhea or vomiting). In addition, neuroleptic agents can interfere with the body's ability to regulate core body temperature, occasionally producing hyperthermia during strenuous exercise, exposure to hot weather, and concomitant treatment with anticholinergic medications. Patients who are dehydrated may be particularly susceptible.

References

  1. "Product Information. Seroquel (quetiapine)." Zeneca Pharmaceuticals, Wilmington, DE.
  2. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company, Indianapolis, IN.
  3. "Product Information. Geodon (ziprasidone)." Pfizer US Pharmaceuticals, New York, NY.
Moderate

Neuroleptics (Includes Thiothixene) ↔ Hyperprolactinemia

Moderate Potential Hazard, Moderate plausibility

Applies to: Breast Cancer, Hyperprolactinemia

The chronic use of neuroleptic agents can cause persistent elevations in prolactin levels due to antagonism of dopamine D2 receptors. Based on in vitro data, approximately one-third of human breast cancers are thought to be prolactin-dependent. The clinical significance of this observation with respect to long-term neuroleptic therapy is unknown. Chronic administration of neuroleptic drugs has been associated with mammary tumorigenesis in rodent studies but not in human clinical or epidemiologic studies. Until further data are available, therapy with neuroleptic agents should be administered cautiously in patients with a previously detected breast cancer. Caution is also advised in patients with preexisting hyperprolactinemia. Hyperprolactinemia may suppress hypothalamic gonadotrophin releasing hormone (GnRH), resulting in reduced pituitary gonadotropin secretion. This, in turn, may inhibit reproductive function by impairing gonadal steroidogenesis in both female and male patients. Galactorrhea, amenorrhea, gynecomastia, and impotence have been reported in patients receiving prolactin-elevating compounds; however, the clinical significance of elevated serum prolactin levels is unknown for most patients. Long-standing hyperprolactinemia when associated with hypogonadism may lead to decreased bone density in both female and male patients.

References

  1. Dickson RA, Dalby JT, Williams R, Edwards AL "Risperidone-induced prolactin elevations in premenopausal women with schizophrenia." Am J Psychiatry 152 (1995): 1102-3
  2. "Product Information. Navane (thiothixene)." Roerig Division, New York, NY.
  3. "Product Information. Moban (molindone)." Gate Pharmaceuticals, Sellersville, PA.
  4. Ash PR, Bouma D "Exaggerated hyperprolactinemia in response to thiothixene ." Arch Neurol 38 (1981): 534-5
  5. Meco G, Falaschi P, Casacchia M, et al "Neuroendocrine effects of haloperidol decanoate in patients with chronic schizophrenia." Adv Biochem Psychopharmacol 40 (1985): 89-93
  6. "Product Information. Compazine (prochlorperazine)." SmithKline Beecham, Philadelphia, PA.
  7. "Product Information. Risperdal (risperidone)." Janssen Pharmaceutica, Titusville, NJ.
  8. Bai YM, Ciu HJ, Guo ZZ "Risperidone-induced hyperprolactinemia in an elderly woman." Am J Psychiatry 159 (2002): 2112
  9. Huang ML, Van Peer A, Woestenborghs R, De Coster R, Heykants J, Jansen AA, Zylicz Z, Visscher HW, Jonkman JH "Pharmacokinetics of the novel antipsychotic agent risperidone and the prolactin response in healthy subjects." Clin Pharmacol Ther 54 (1993): 257-68
  10. "Product Information. Seroquel (quetiapine)." Zeneca Pharmaceuticals, Wilmington, DE.
  11. "Product Information. Geodon (ziprasidone)." Pfizer US Pharmaceuticals, New York, NY.
  12. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals, East Hanover, NJ.
  13. "Product Information. Loxitane C Oral Concentrate (loxapine)" Watson Laboratories Inc, Corona, CA.
  14. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical, Raritan, NJ.
  15. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company, Indianapolis, IN.
  16. "Product Information. Orap Tablets (pimozide)." Gate Pharmaceuticals, Sellersville, PA.
View all 16 references
Moderate

Neuroleptics (Includes Thiothixene) ↔ Liver Disease

Moderate Potential Hazard, High plausibility

Applies to: Liver Disease

Most neuroleptic agents are extensively metabolized by the liver. The plasma concentrations of these agents may be increased and the half-lives prolonged in patients with impaired hepatic function. Therapy with neuroleptic agents should be administered cautiously in patients with significant liver disease. Lower initial dosages and slower titration may be appropriate.

References

  1. Hobbs DC "Metabolism of thiothixene." J Pharm Sci 57 (1968): 105-11
  2. "Product Information. Geodon (ziprasidone)." Pfizer US Pharmaceuticals, New York, NY.
  3. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company, Indianapolis, IN.
  4. Jann MW, Grimsley SR, Gray EC, Chang WH "Pharmacokinetics and pharmacodynamics of clozapine." Clin Pharmacokinet 24 (1993): 161-76
  5. "Product Information. Navane (thiothixene)." Roerig Division, New York, NY.
  6. "Product Information. Moban (molindone)." Gate Pharmaceuticals, Sellersville, PA.
  7. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals, East Hanover, NJ.
  8. "Product Information. Loxitane C Oral Concentrate (loxapine)" Watson Laboratories Inc, Corona, CA.
  9. Hobbs DC, Welch WM, Short MJ, Moody WA, Van der Velde CD "Pharmacokinetics of thiothixene in man." Clin Pharmacol Ther 16 (1974): 473-8
  10. Heel RC, Brogden RN, Speight TM, Avery GS "Loxapine: a review of its pharmacological properties and therapeutic efficacy as an antipsychotic agent." Drugs 15 (1978): 198-217
  11. "Product Information. Seroquel (quetiapine)." Zeneca Pharmaceuticals, Wilmington, DE.
View all 11 references
Moderate

Neuroleptics (Includes Thiothixene) ↔ Parkinsonism

Moderate Potential Hazard, High plausibility

Applies to: Parkinsonism

The use of neuroleptic agents is associated with pseudo-parkinsonian symptoms such as akinesia, bradykinesia, tremors, pill-rolling motion, cogwheel rigidity, and postural abnormalities including stooped posture and shuffling gait. The onset is usually 1 to 2 weeks following initiation of therapy or an increase in dosage. Older neuroleptic agents such as haloperidol are more likely to induce these effects, and their use may be contraindicated in patients with Parkinson's disease or parkinsonian symptoms.

References

  1. Moleman P, Janzen G, von Bargen BA, et al "Relationship between age and incidence of parkinsonism in psychiatric patients treated with haloperidol." Am J Psychiatry 143 (1986): 232-4
  2. Pinder RM, Brogden RN, Swayer R, Speight TM, Spencer R, Avery GS "Pimozide: a review of its pharmacological properties and therapeutic uses in psychiatry." Drugs 12 (1976): 1-40
  3. "Product Information. Orap Tablets (pimozide)." Gate Pharmaceuticals, Sellersville, PA.
  4. Boston Collaborative Drug Surveillance Program "Drug-induced extrapyramidal symptoms." JAMA 224 (1973): 889-91
  5. "Product Information. Loxitane C Oral Concentrate (loxapine)" Watson Laboratories Inc, Corona, CA.
  6. Gwinn KA, Caviness JN "Risperidone-induced tardive dyskinesia and parkinsonism." Mov Disord 12 (1997): 119-21
  7. Sheppard C, Merlis S "Drug-induced extrapyramidal symptoms: their incidence and treatment." Am J Psychiatry 123 (1967): 886-9
  8. Mahmood T, Clothier EB, Bridgman R "Risperidone-induced extrapyramidal reactions." Lancet 346 (1995): 1226
  9. Heel RC, Brogden RN, Speight TM, Avery GS "Loxapine: a review of its pharmacological properties and therapeutic efficacy as an antipsychotic agent." Drugs 15 (1978): 198-217
  10. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical, Raritan, NJ.
  11. "Product Information. Moban (molindone)." Gate Pharmaceuticals, Sellersville, PA.
  12. DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM "Pharmacotherapy: A Pathophysiologic Approach 4th" Stamford, CT: Appleton & Lange (1999):
  13. Bransgrove LL, Kelly MW "Movement disorders in patients treated with long-acting injectable antipsychotic drugs." Am J Hosp Pharm 51 (1994): 895-9
  14. Owens DGC "Extrapyramidal side effects and tolerability of risperidone - a review." J Clin Psychiatry 55 Suppl (1994): 29-35
View all 14 references
Moderate

Thiothixene (Includes Thiothixene) ↔ Breast Cancer

Moderate Potential Hazard, Moderate plausibility

Applies to: Breast Cancer

The chronic use of thiothixene is associated with persistent elevations in prolactin levels. Based on in vitro data, approximately one-third of human breast cancers are thought to be prolactin-dependent. The clinical significance of this observation is unknown. Although disturbances such as galactorrhea, amenorrhea, gynecomastia, and impotence have been reported, the clinical significance of elevated serum prolactin levels is unknown for most patients. Chronic administration of antipsychotic drugs has been associated with mammary tumorigenesis in rodent studies but not in human clinical or epidemiologic studies. Therapy with thiothixene should be administered cautiously in patients with existing or suspected malignancy of the breast.

Moderate

Thiothixene (Includes Thiothixene) ↔ Convulsions

Moderate Potential Hazard, Moderate plausibility

Applies to: Alcoholism, Seizures

The use of thiothixene may precipitate convulsions. Therapy with thiothixene should be administered cautiously in patients with a history of convulsive disorders or those in a state of alcohol withdrawal, since it may lower the convulsive threshold.

Moderate

Thiothixene (Includes Thiothixene) ↔ Dystonia

Moderate Potential Hazard, Moderate plausibility

Applies to: Dehydration, Hypocalcemia

Thiothixene may cause dose-related dystonic reactions, prolonged abnormal contractions of muscle groups, may occur in susceptible individuals during the first few days of treatment. These reactions are characterized by spastic contraction of discrete muscle groups that may include spasm of the neck muscles, sometimes progressing to tightness of the throat, swallowing difficulty, difficulty breathing, and/or protrusion of the tongue. Therapy with thiothixene should be administered cautiously in patients, particularly males and children, with hypocalcemia or severe dehydration, since these patients may be more susceptible to dystonic reactions.

Moderate

Thiothixene (Includes Thiothixene) ↔ Hyperprolactinemia

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyperprolactinemia

The use of thiothixene may elevate prolactin levels and the elevation may persists during chronic administration. Hyperprolactinemia may suppress hypothalamic gonadotrophin releasing hormone (GnRH), resulting in reduced pituitary gonadotropin secretion. This, in turn, may inhibit reproductive function by impairing gonadal steroidogenesis in both female and male patients. Galactorrhea, menstrual irregularities, amenorrhea, and gynecomastia have occurred in a small percentage of females receiving thiothixene; however, the clinical significance of elevated serum prolactin levels is unknown for most patients

Moderate

Thiothixene (Includes Thiothixene) ↔ Liver Impairment

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

The use of thiothixene has been associated with transient elevations of serum transaminase and alkaline phosphatase. No clinically confirmed cases of jaundice attributable to thiothixene have been reported. Care should be exercised when using this agent in patients with liver impairment and it is recommended to monitor liver enzymes before the start of therapy and periodically thereafter as clinically appropriate.

Moderate

Thiothixene (Includes Thiothixene) ↔ Nms

Moderate Potential Hazard, Moderate plausibility

Applies to: Neuroleptic Malignant Syndrome

The use of thiothixene may precipitate or aggravate a potentially fatal symptom complex known as Neuroleptic Malignant Syndrome (NMS). NMS is observed most frequently when high-potency neuroleptic agents like haloperidol or fluphenazine are administered intramuscularly but may occur with any antipsychotic drugs, including thiothixene. Clinical manifestations of NMS include hyperpyrexia, muscle rigidity, altered mental status and autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis and cardiac arrhythmias). Phenothiazine therapy should not be initiated in patients with active NMS and should be immediately discontinued if currently being administered in such patients. In patients with a history of NMS, introduction or reintroduction of thiothixene should be carefully considered, since NMS may recur.

Moderate

Thiothixene (Includes Thiothixene) ↔ Parkinsonism

Moderate Potential Hazard, Moderate plausibility

Applies to: Parkinsonism

The use of thiothixene is associated with pseudo-parkinsonian symptoms such as akinesia, bradykinesia, tremors, pill-rolling motion, cogwheel rigidity, and postural abnormalities including stooped posture and shuffling gait. Therapy with thiothixene should be administered cautiously in patients with Parkinson's disease or parkinsonian symptoms.

Moderate

Thiothixene (Includes Thiothixene) ↔ Respiratory Disorders

Moderate Potential Hazard, Moderate plausibility

Applies to: Pulmonary Impairment

Thiothixene may suppress the cough reflex. Therapy with thiothixene should be administered cautiously in patients with chronic respiratory disorders, including severe asthma, emphysema, or acute respiratory tract infections.

thiothixene drug Interactions

There are 859 drug interactions with thiothixene

thiothixene alcohol/food Interactions

There is 1 alcohol/food interaction with thiothixene

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

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Further information

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