氟奋乃静, 以 Prolixin 等品牌出售, 是一种抗精神病药物。[1] 它用于治疗慢性精神病，例如精神分裂症,[1][2] 其疗效似乎与氯丙嗪等低效抗精神病药物相当。[3] 它是通过嘴给予的, 注射到肌肉中, or just under the skin.[1] There is also a long acting injectable version that may last for up to four weeks.[1] Fluphenazine decanoate, the depot injection form of fluphenazine, should not be used by people with severe depression.[4]
Common side effects include movement problems, sleepiness, depression and increased weight.[1] Serious side effects may include neuroleptic malignant syndrome, low white blood cell levels, and the potentially permanent movement disorder tardive dyskinesia.[1] In older people with psychosis as a result of dementia it may increase the risk of dying.[1] It may also increase prolactin levels which may result in milk production, enlarged breasts in males, impotence, and the absence of menstrual periods.[1] It is unclear if it is safe for use in pregnancy.[1]
Fluphenazine is a typical antipsychotic of the phenothiazine class.[1] Its mechanism of action is not entirely clear but believed to be related to its ability to block dopamine receptors.[1] In up to 40% of those on long term phenothiazines, liver function tests become mildly abnormal.[5]
Fluphenazine came into use in 1959.[6] The injectable form is on the World Health Organization’s List of Essential Medicines.[7] It is available as a generic medication.[1] It was discontinued in Australia around mid 2017.[8]
医疗用途
A 2018 Cochrane review found that fluphenazine was an imperfect treatment and other inexpensive drugs less associated with side effects may be an equally effective choice for people with schizophrenia.[9]
Side effects
停产
英国国家处方集建议在停用抗精神病药物时逐渐停药，以避免急性戒断综合征或快速复发。[10] 戒断症状通常包括恶心, 呕吐, 和食欲不振。[11] 其他症状可能包括烦躁不安, 出汗增多, 和睡眠困难。[11] 不太常见的是，可能会有一种世界旋转的感觉, 麻木, 或肌肉疼痛。[11] 症状通常会在短时间内消失。[11]
有初步证据表明，停用抗精神病药物可能会导致精神病。[12] 它还可能导致正在治疗的病症复发。[13] 停止用药时很少会出现迟发性运动障碍。[11]
药理
Pharmacodynamics
也可以看看: Antipsychotic § Pharmacodynamics, and Antipsychotic § Comparison of medications
Fluphenazine acts primarily by blocking post-synaptic D2 receptors in the basal ganglia, cortical and limbic system. It also blocks alpha-1 adrenergic receptors, muscarinic-1 receptors, and histamine-1 receptors.[14][15]
