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Loxitane (Loxapine)

Description

Generic - loxapine succinate
Drug class - Miscellaneous antipsychotic agents
Main Indication - schizophrenia, agitation
Manufacturer - Wy Pharma Inc.
Pregnancy category - not classified
FDA records - starting from 1975
Administration type - oral intake


Agitation (excessive motor and verbal stimulation), often found in various psychiatric disorders, is the condition escalation of which leads to aggressive behaviour in patients, posing a threat to the patient himself as well as others. In 2011, the Office for the quality control of foods and drugs Administration (FDA) has approved a brand-new drug, Loxitane, primarily designed for elimination of agitation manifestations in schizophrenia or bipolar disorder patients. In the US the drug is available by prescription only; it is manufactured in the form of capsules containing from 5 up to 50mg of active ingredient, loxapine succinate.

The drugs used for the treatment of agitation, must meet a number of requirements: provide a high level of therapeutic response, provide toleration capabilities and have a rapid onset of sedation (up to 60 minutes, severe sedation or sleep are not regarded as a mandatory component of the action, but rather as the undesirable effects). In the current guidelines for the management of agitation, intramuscular administration of benzodiazepines with short half-life is recommended; however, Loxitane is oftentimes considered as a decent alternative to these options.

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The challenge of treatment

Even with an established diagnosis of a psychotic disorder agitation, the treatment may be accompanied by considerable difficulties. The occurrence of condition can be due to many reasons depending on the particular episode. Common causes of agitation in schizophrenia or bipolar disorder is substance intoxication, persistent hallucinations or delusions and impulsiveness. The sharp deterioration in the mental condition contributes to somatic diseases or iatrogenic causes, such as akathisia caused by antipsychotics or antidepressants. The goal of treatment is providing rapid sedative effect for the patient within a minimum timeframe possible to prevent the risk of a patient harming himself or others. For this purpose the nonspecific sedatives such as benzodiazepines and / or antipsychotics which can also be used to treat underlying mental disorder. Loxitane can be used as a drug for maintenance treatment as well as within a treatment course due to a quick onset of action.

Pharmacological action

Loxitane represents the relatively new class of drugs - antipsychotics. Like most drugs of this group, it works to block dopamine D2-receptor and provide clinically significant antagonism of 5-HT2A-receptors of serotonin.

Clinical effectiveness

In clinical trials the preparation at 5 and 10 mg dosage shows a significant against the background of placebo in reducing grade of the severity of symptoms in 10 minutes and the second hour after administration of the preparation: the effectiveness and the onset of action are comparable with the lineup of drugs for administered intravenously.

Dosage and administration

The preparation is designed for oral intakes; the starting dose equals 10 mg split into two intakes daily. An increase in the dosage is allowed in patients suffering from high disturbance symptoms (up to 50mg dosage is allowed). The dosage increase should be made gradually during the period of 7 - 10 days and conducted with monitoring of schizophrenia development. As a rule, the maintenance and therapeutic dose ranges vary from 60mg to 100mg each 24 hours. The maximum daily dosage is 250mg. The dosage should be selected by the treating doctor and the course of treatment is preferably conducted under supervision of medical personnel.

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