Indications

Flupentixol and Melitracen tablet is indicated in-
  • Anxiety
  • Depression
  • Apathy
  • Psychogenic depression.
  • Depressive neurosses.
  • Masked depression.
  • Psychosomatic affections accompanied by anxiety and apathy.
  • Menopausal depressions.
  • Dysphoria and depression in alcoholics and drug addicts.

Therapeutic Class

Combined anxiolytics & anti-depressant drugs

Pharmacology

This consists of two well known and well proven compounds: flupentixol-a neuroleptic with anxiolytic and antidepressant properties of its own when given in small doses, and melitracen-a bipolar thymoleptic with activating properties in low doses. In combination the compounds render a preparation with antidepressant, anxiolytic and activating properties. Maximal serum concentration is reached in about 4 hours after oral administration of flupentixol and in about 4 hours after oral administration of melitracen. The biological half-life of flupentixol is about 35 hours and that of melitracen is about 19 hours. The combination of flupentixol and melitracen does not seem to influence the pharmacokinetic properties of the individual compounds.

Dosage

Adults: Usually 2 tablets orally daily in the morning and noon. In severe cases, the morning dose may be increased to 2 tablets.

Elderly patients: 1 tablet in the morning.

Maintenance dose: Usually 1 tablet orally in the morning. In cases of insomnia or severe restlessness, additional treatment with a sedative in the acute phase is recommended.

Interactions

This tablet may enhance the response to alcohol, barbiturates and other CNS depressants. Simultaneous administration of MAO-inhibitors may cause hypertensive crises. Neuroleptics and thymoleptics reduce the antihypertensive effect of guanethidine and similar acting compounds and thymoleptics enhance the effects of adrenaline and noradrenaline.

Contraindications

  • The immediate recovery phase after myocardial infarction.
  • Defects in bundle-branch conduction.
  • Untreated narrow-angle glaucoma.
  • Acute alcohol, barbiturate and opiate intoxications.
  • This tablet should not be given to patients who have received an MAO-inhibitor within two weeks.
  • Not recommended for excitable or overactive patients since its activating effect may lead to exaggeration of these characteristics.

Side Effects

In the recommended doses side effects are rare. These could be transient restlessness and insomnia.

Pregnancy & Lactation

This tablet should preferably not be given during pregnancy and lactation.

Precautions

If previously the patient has been treated with tranquillizers with sedative effect these should be withdrawn gradually.

Overdose

In cases of overdosage the symptoms of intoxications by melitracen, especially of anticholinergic nature, dominate. More rarely extrapyramidal symptoms due to flupentixol occur. Symptomatic and Supportive. Gastric lavage should be carried out as soon as possible and activated charcoal may be administered. Measures aimed at supporting the respiratory and cardiovascular systems should be instituted. Epinephrine (adrenaline) must not be used for such patients. Convulsions may be treated with diazepam and extrapyramidal symptoms with biperiden.

Storage Conditions

Store at a temperature not exceeding 30°C in a dry place. Protect from light. Keep out of reach of children.