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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Should Zuclopenthixol Be Continued?

Hi, My brother is mentally brain damaged and has epilepsy he is on a range of medicines to mainly control his behaviour. he has been on Zuclopenthixol long term (many years) 30mg a day . the problem is the care home/has advised my parents give him an extra tablet a day when he is home as his behaviour has been increasingly difficult on visits. Most problems stem from his drop down fits/jerks where he falls and then lashes out in confusion. There has been a broken chain of knowledge r.e doctors and his medicine and in my opinion from what I have researched he shouldn't be on this medicine- the jerks and drop downs can be potentially from the drug and people prone to seizures shouldnt take it and form what I can gather noone should take it for so long. please advise
Mon, 26 Feb 2018
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Neurologist,  's  Response
I read your question carefully and I understand your concern.

It is true that antipsychotics like Zuclopenthixol can lower the threshold for seizures to some extent. However there are a couple of considerations to make. First is whether those episodes you describe are actually seizures. It is not uncommon for patients to have non epileptic psychogenic episodes. It may be that the doctors believe these episodes to be of such nature. The second issue is that sometimes even though it is known to have side effects antipsychotics are a necessary evil ass the patients are otherwise impossible to control.
I am not saying that your concerns are wrong, you should definitely raise them with the doctors, only want you to consider that at times there is no perfect solution and they may have their reasons for using that drug in an epileptic patient (reasons which they should explain to you though).

I hope to have been of help.
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Should Zuclopenthixol Be Continued?

I read your question carefully and I understand your concern. It is true that antipsychotics like Zuclopenthixol can lower the threshold for seizures to some extent. However there are a couple of considerations to make. First is whether those episodes you describe are actually seizures. It is not uncommon for patients to have non epileptic psychogenic episodes. It may be that the doctors believe these episodes to be of such nature. The second issue is that sometimes even though it is known to have side effects antipsychotics are a necessary evil ass the patients are otherwise impossible to control. I am not saying that your concerns are wrong, you should definitely raise them with the doctors, only want you to consider that at times there is no perfect solution and they may have their reasons for using that drug in an epileptic patient (reasons which they should explain to you though). I hope to have been of help.