Fluspirilene

{{Short description|Typical antipsychotic medication}}

{{Drugbox

| verifiedrevid = 414250678

| IUPAC_name = 8-[4,4-Bis(4-fluorophenyl)butyl]-1-phenyl-1,3,8-triazaspiro[4.5]decan-4-one

| image = Fluspirilene.svg

| image_class = skin-invert-image

| width = 270

| tradename = Imap

| Drugs.com = {{drugs.com|international|fluspirilene}}

| pregnancy_category =

| legal_status = Rx-only

| routes_of_administration = IM

| bioavailability =

| protein_bound =

| metabolism =

| elimination_half-life =

| excretion =

| CAS_number_Ref = {{cascite|correct|??}}

| CAS_number = 1841-19-6

| ATC_prefix = N05

| ATC_suffix = AG01

| PubChem = 3396

| IUPHAR_ligand = 85

| DrugBank_Ref = {{drugbankcite|correct|drugbank}}

| DrugBank = DB04842

| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}

| ChemSpiderID = 3279

| UNII_Ref = {{fdacite|correct|FDA}}

| UNII = C5QA4GLR9M

| KEGG_Ref = {{keggcite|correct|kegg}}

| KEGG = D02629

| ChEMBL_Ref = {{ebicite|correct|EBI}}

| ChEMBL = 46516

| C=29 | H=31 | F=2 | N=3 | O=1

| smiles = Fc1ccc(cc1)C(c2ccc(F)cc2)CCCN5CCC4(C(=O)NCN4c3ccccc3)CC5

| StdInChI_Ref = {{stdinchicite|correct|chemspider}}

| StdInChI = 1S/C29H31F2N3O/c30-24-12-8-22(9-13-24)27(23-10-14-25(31)15-11-23)7-4-18-33-19-16-29(17-20-33)28(35)32-21-34(29)26-5-2-1-3-6-26/h1-3,5-6,8-15,27H,4,7,16-21H2,(H,32,35)

| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}

| StdInChIKey = QOYHHIBFXOOADH-UHFFFAOYSA-N

}}

Fluspirilene (Redeptin, Imap, R6218) is a diphenylbutylpiperidine typical antipsychotic drug, used for the treatment of schizophrenia.{{cite journal | author = van Epen JH | title = Experience with fluspirilene (R 6218), a long-acting neuroleptic | journal = Psychiatr Neurol Neurochir | year = 1970 | volume = 73| issue = 4 | pages = 277–284 | pmid = 5478771}} It is administered intramuscularly.{{cite journal | vauthors=Janssen PA, Niemegeers CJ, Schellekens KH, Lenaerts FM, Verbruggen FJ, van Nueten JM, Marsboom RH, Hérin VV, Schaper WK | title = The pharmacology of fluspirilene (R 6218), a potent, long-acting and injectable neuroleptic drug | journal = Arzneimittelforschung | year = 1970 | volume = 20 | issue = 11 | pages = 1689–1698 | pmid = 4992598}} It was discovered at Janssen Pharmaceutica in 1963.{{cite patent | assign1 = C. Janssen, NV Res. Lab. |country=BE|number=633914 | gdate = 1963 }} A 2007 systematic review investigated the efficacy of fluspirilene decanoate for people with schizophrenia:

class="wikitable" |+ Fluspirilene decanoate compared to oral antipsychotics{{cite journal | vauthors = Abhijnhan A, Adams CE, David A, Ozbilen M | title = Depot fluspirilene for schizophrenia | journal = The Cochrane Database of Systematic Reviews | volume = 2007 | issue = 1 | pages = CD001718 | date = January 2007 | pmid = 17253464 | pmc = 7025783 | doi = 10.1002/14651858.CD001718.pub2 }}
Summary
Participant numbers in each comparison were small so power to identify clear difference is limited. Randomized controlled trial data identified no clear differences between the long-acting injection of fluspirilene and oral medication for outcomes that include adverse effects.
style="padding:0;" | {| class="wikitable collapsible collapsed" style="width:100%;"
scope="col" style="text-align: left;"| Outcome ! scope="col" style="text-align: left;"| Findings in words ! scope="col" style="text-align: left;"| Findings in numbers ! scope="col" style="text-align: left;"| Quality of evidence
colspan="4" style="text-align: left;"| Global outcome
Leaving the study early Follow up: 6 weeks to 5 months	Fluspirilene decanoate may increase the risk of leaving the study (reasons not specified), but, the difference is not clear between people given fluspirilene decanoate and those receiving oral antipsychotics. These findings are based on data of low quality.	RR 1.18 (0.08 to 16.78)	Low
colspan="4" style="text-align: left;"| Mental state
Relapse Follow up: 6 weeks to 5 months	Using the depot, long-acting fluspirilene decanoate makes little difference for the outcome of 'relapse' compared with those receiving oral antipsychotics - at least for those willing to be engaged with trials. These findings are based on data of low quality.	RR 1.18 (0.08 to 16.78)	Low
colspan="4" style="text-align: left;"| Adverse effects
Needing anticholinergic drugs Follow up: 6 weeks to 5 months	The depot fluspirilene decanoate does not seem to cause any more movement disorders - for which anticholinergic drugs are used - compared with oral antipsychotics. These findings are based on data of low quality.	RR 0.07 (0.00 to 1.07)	Low
Dizziness	Fluspirilene decanoate may reduce the chance of experiencing dizziness compared with the oral antipsycotics. Data are based on low quality evidence.	RR 0.59 (0.37 to 0.95)	Low
colspan="4" style="text-align: left;"| Missing outcomes
	Data on quality of life, and service use (e.g. hospitalization) were not reported in trials.

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{{Pharmacokinetics of long-acting injectable antipsychotics}}