Zuclopenthixol decanoate

Clopixol Depot·Psychiatry - Depot Antipsychotics

Maintenance treatment of Schizophrenia and other psychoses, particularly with associated aggression/agitation

Authority requiredPBSDEPOT Q2-4WClopixol DepotS4+1

Max Dose

600 mg/week

Half-life

17 Days

Sedation

SEVERE

EPS Risk

HIGH

Rapid Summary

Overview

First-Generation Antipsychotic (FGA) depot in fractionated coconut oil. Highly sedating. The ultimate 'calming' depot for chronically violent or severely agitated patients.

Maximum Dose

Max 600 mg/week (Though typical doses are 200-400 mg every 2-4 weeks).

Clinical Focus

Patients are frequently 'zombified' by this drug. It provides excellent behavioral control but causes profound lethargy and blunting.

Bottom Line

Zuclopenthixol decanoate is a depot antipsychotic for maintenance treatment of chronic psychosis, but causes significant extrapyramidal effects and is irreversible once injected (2-4 week duration).

Formulation & Access

Brand Names

Clopixol Depot

Parenteral

Ampoules (200 mg/1 mL). Thick oil solution.

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

Maintenance treatment of Schizophrenia and other psychoses, particularly with associated aggression/agitation.

Clinical Place

Reserved for the most severely agitated, aggressive, or non-compliant patients who fail modern SGAs.

Quick reference

Class & Role

Clopixol Depot — First-Generation Antipsychotic (FGA) depot in fractionated coconut oil.

Route / Formulation

Ampoules (200 mg/1 mL). Thick oil solution. (Clopixol Depot)

Usual Dose & Max

IM 200-400 mg every 2 to 4 weeks. Deep gluteal Z-Track injection. Max 600 mg/week (Though typical doses are 200-400 mg every 2-4 weeks).

Key Indication Doses

Schizophrenia / Severe Agitation: IM 200-400 mg every 2 to 4 weeks. Deep gluteal Z-Track injection. Elderly / Frail: Max 50-100 mg every 4 weeks. (Extreme risk of falls/sedation).

Best Uses

Zuclopenthixol decanoate is a depot antipsychotic for maintenance treatment of chronic psychosis, but causes significant extrapyramidal effects and is irreversible once injected (2-4 week duration).

Avoid / Cautions

Parkinson's disease, severe cardiovascular disease, acute severe CNS depression. Pregnancy Category C.

Key Risks

Neurological: Severe sedation, apathy, EPS (Parkinsonism, acute dystonia). Cardiovascular: Orthostatic hypotension, tachycardia. Metabolic: Weight gain (less than Olanzapine, but high for an FGA).

Key Interactions

Synergistic respiratory depression with high-dose Benzodiazepines or Opioids. Antihypertensives (Additive hypotension).

Monitoring

Monitor for over-sedation and falls, especially in the 3-4 days immediately following the injection. Baseline ECG, Lipids, and Weight.

Clinical Pearl

While modern psychiatry prefers non-sedating drugs (like Aripiprazole), Zuclopenthixol Depot remains essential in forensic or high-acuity wards where the patient's baseline aggression poses a physical danger to staff and themselves.

Access

Authority requiredClopixol Depot

Brand: Clopixol Depot
PBS status: Authority required

Zuclopenthixol decanoate

Clopixol Depot·Psychiatry - Depot Antipsychotics

Maintenance treatment of Schizophrenia and other psychoses, particularly with associated aggression/agitation

Authority requiredPBSDEPOT Q2-4WClopixol DepotS4+1

Max Dose

600 mg/week

Half-life

17 Days

Sedation

SEVERE

EPS Risk

HIGH

Rapid Summary

Overview

First-Generation Antipsychotic (FGA) depot in fractionated coconut oil. Highly sedating. The ultimate 'calming' depot for chronically violent or severely agitated patients.

Maximum Dose

Max 600 mg/week (Though typical doses are 200-400 mg every 2-4 weeks).

Clinical Focus

Patients are frequently 'zombified' by this drug. It provides excellent behavioral control but causes profound lethargy and blunting.

Bottom Line

Zuclopenthixol decanoate is a depot antipsychotic for maintenance treatment of chronic psychosis, but causes significant extrapyramidal effects and is irreversible once injected (2-4 week duration).

Formulation & Access

Brand Names

Clopixol Depot

Parenteral

Ampoules (200 mg/1 mL). Thick oil solution.

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

Maintenance treatment of Schizophrenia and other psychoses, particularly with associated aggression/agitation.

Clinical Place

Reserved for the most severely agitated, aggressive, or non-compliant patients who fail modern SGAs.

Quick reference

Class & Role

Clopixol Depot — First-Generation Antipsychotic (FGA) depot in fractionated coconut oil.

Route / Formulation

Ampoules (200 mg/1 mL). Thick oil solution. (Clopixol Depot)

Usual Dose & Max

IM 200-400 mg every 2 to 4 weeks. Deep gluteal Z-Track injection. Max 600 mg/week (Though typical doses are 200-400 mg every 2-4 weeks).

Key Indication Doses

Schizophrenia / Severe Agitation: IM 200-400 mg every 2 to 4 weeks. Deep gluteal Z-Track injection. Elderly / Frail: Max 50-100 mg every 4 weeks. (Extreme risk of falls/sedation).

Best Uses

Zuclopenthixol decanoate is a depot antipsychotic for maintenance treatment of chronic psychosis, but causes significant extrapyramidal effects and is irreversible once injected (2-4 week duration).

Avoid / Cautions

Parkinson's disease, severe cardiovascular disease, acute severe CNS depression. Pregnancy Category C.

Key Risks

Neurological: Severe sedation, apathy, EPS (Parkinsonism, acute dystonia). Cardiovascular: Orthostatic hypotension, tachycardia. Metabolic: Weight gain (less than Olanzapine, but high for an FGA).

Key Interactions

Synergistic respiratory depression with high-dose Benzodiazepines or Opioids. Antihypertensives (Additive hypotension).

Monitoring

Monitor for over-sedation and falls, especially in the 3-4 days immediately following the injection. Baseline ECG, Lipids, and Weight.

Clinical Pearl

Access

Authority requiredClopixol Depot

Brand: Clopixol Depot
PBS status: Authority required