FLUPENSCOT

*Schizophrenia and other psychoses, particularly with apathy and withdrawal but not mania or psychomotor hyperactivity:* ORAL: Adult: Initially 3-9 mg twice daily, adjusted according to response, for debilitated patients, use elderly dose; max. 18 mg per day. Elderly: Initially 0.75-4.5 mg twice daily, adjusted according to response. BY DEEP IM INJ: Adult: Test dose 20 mg, then after at least 7 days 20-40 mg repeated at intervals of 2-4 weeks, adjusted according to response; max 400 mg weekly; usual maintenance dose 50 mg every 4 weeks to 300 mg every 2 weeks. Elderly: Initially quarter to half adult dose. *Depressive illness with or without anxiety:* ORAL: Adult: Initially 1 mg once daily in the morning, increased if necessary to 2 mg after 1 week, doses above 2 mg to be given in divided doses, last dose to be taken before 4 pm; discontinue if no response after 1 week at max. dosage; max 3 mg per day. Elderly: Initially 500 mcg daily in the morning, then increased if necessary to 1 mg after 1 week, doses above 1mg to be given in divided doses, last dose to be taken before 4 pm; discontinue if no response after 1 week at max. dosage; max 1.5 mg per day.

Administer only by deep IM injection into the upper outer buttock or lateral thigh not for IV use. Store at room temperature. Protect from light.

CNS depression, comatose states, states of excitement or over-activity including mania, impaired consciousness, phaeochromocytoma, circulatory collapse, coma.

Acute porphyrias, cardiac disorders, cerebral arteriosclerosis, renal, hepatic, respiratory or cardiovascular disease, arrhythmias, epilepsy, Parkinsons disease, glaucoma, prostatic hypertrophy, thyroid disorders, myasthenia gravis, elderly, pheochromocytoma, risk factors for stroke, QT prolongation or venous thromboembolism, risk of neuroleptic malignant syndrome; discontinue treatment if occurs. Risk of blood dyscrasias; monitor for suicidal ideation. Withdraw gradually.

Adrenaline, alcohol, barbiturates, CNS depressants, antipsychotics, anticholinergics, levodopa, antihypertensives, anticonvulsants, drugs that prolong the QT interval (e.g. class I and III antiarrhythmics, thioridazine, erythromycin. Moxifioxacin, some antihistamines), drugs known to cause electrolytes disturbances, lithium, metoclopramide, general anaesthetics, anticoagulants, neuromuscular blocking agents, quinidine, corticosteroids, digoxin.

Asthenia, dyspnea, hypersalivation, myalgia, sudden death, torsade de pointes, blood dyscrasias, hyperprolactinaemia, acute dystonias and dyskinesias, akathisia, Parkinsonism, hypotension, anticholinergic effects (e.g. dry mouth, blurred vision), respiratory depression, nasal stuffiness, rash, photosensitivity, hyperglycaemia, convulsions, male sexual dysfunction, gynaecomastia, amenorrhoea, galactorrhoea, hyperhidrosis, somnolence, fatigue, GI upset, agranulocytosis, jaundice, neuroleptic malignant syndrome, QT prolongation.