Thiothixene
NAVANE
What it isD2-predominant thioxanthene antipsychotic; schizophrenia.
Why this oneIts niche is an inexpensive oral typical with less sedation and antimuscarinic toxicity than low-potency agents, but no depot form.
What limits itAkathisia, parkinsonism, and tardive dyskinesia commonly limit use; QT prolongation and NMS remain serious risks.
FDA-approved for
- schizophrenia (~1967)
FDA label
Read the full label on DailyMed ↗
BOXED WARNING Increased mortality in elderly patients with dementia-related psychosis treated with antipsychotics; not approved for dementia-related psychosis.
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Schizophrenia (milder) | Adults | 2 mg TID | 15 mg/day | 60 mg/day |
| Schizophrenia (more severe) | Adults | 5 mg BID | 20-30 mg/day | 60 mg/day |
Renal Undefined
Hepatic Undefined
Exceeding 60 mg/day rarely increases benefit
Instructions
- Individualize dose; start small and increase gradually to optimal effect
- Some patients maintained on once-daily dosing
- Not recommended in children under 12 years
Contraindications
- Circulatory collapse
- Comatose states or CNS depression due to any cause
- Blood dyscrasias
Cautions
- Tardive dyskinesia with long-term use
- Neuroleptic malignant syndrome (NMS)
- Extrapyramidal symptoms and dystonia, especially early and at higher doses
- Orthostatic hypotension/syncope (do not use epinephrine as pressor)
- Seizures; sedation
Adverse reactions
- Tachycardia, hypotension, lightheadedness, syncope
- Drowsiness, restlessness, agitation, insomnia
- Extrapyramidal symptoms, dystonia, tardive dyskinesia
- Dry mouth, blurred vision, constipation
- Hyperprolactinemia, menstrual irregularities
Pregnancy Undefined
Lactation Undefined
⚠ BOXED WARNING
- Increased mortality in elderly patients with dementia-related psychosis
Cost, est. cash$10–$300/month
Generic entry1987
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityMetabolic effects, extrapyramidal symptoms/tardive dyskinesia and agent-specific QT or orthostatic risk.
Mechanism of action: Thiothixene ballicule
Open Thiothixene in the interactive console ↗
Memory aids: mascots and interaction avatars
spooky mascot in greyscale → high potency first-gen antipsychotic
