University Health System
PSYCHIATRIC SERVICES
Antipsychotics
"Depot" Injectable Typical Neuroleptics
Fluphenazine Decanoate (Prolixin Decanoate®)
Haloperidol Decanoate (Haldol Decanoate®)
Course of Treatment: _________________________________________________________________________________
PURPOSE AND GENERAL INFORMATION
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This medication is used to treat a variety of psychiatric
problems such as overactivity, preoccupation with troublesome and recurring
thoughts, and unpleasant and unusual experiences such as hearing and seeing
things not normally heard nor seen. This medication will reduce or stop
these experiences and help you remain outside the hospital.
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This medication cannot "cure" the illness, but it can take
away many of the symptoms or make them milder. It is important to take
this medication as directed, even when you begin to feel better. It is
necessary to continue taking this medication in order to keep feeling well.
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Depot medication is an alternative to taking medicine by
mouth. An injection is used to deposit medication into muscle tissue and
from there the medication is slowly released into your system over a number
of weeks. When medication is taken by mouth, it is quickly absorbed through
the stomach and intestines; unfortunately, much of it is lost in this digestive
process.
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This medication does not produce euphoria (a high feeling)
and is not addictive.
BENEFITS
Relief of Symptoms
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Reduction or elimination of voices or visions not heard nor
seen by others.
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Reduction or elimination of frightening or strange beliefs
and ideas not shared by others.
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Decreased tension and agitation with more calm, relaxed feelings.
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Improved concentration and clearer thinking; better control
over thoughts and feelings with less hostile, strange, or aggressive thoughts.
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Reduced fears, confusion, and insomnia.
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Improved coherence of speech with greater ability to express
oneself and to be understood by others.
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Happier, brighter, and healthier feelings.
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Increased ability to act more appropriately without wanting
to laugh, cry, or smile for no apparent reason.
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Increased ability to care for oneself, reducing the neglect
of appearance and personal hygiene.
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Prevention or delay of relapses and the need for re-hospitalization.
Depot vs. Oral Treatment
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One depot injection can replace oral daily dosing for up
to one month. Therefore, you no longer have to remember to take your medication
every day, and your medication is not a daily reminder of your illness.
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To keep symptoms from interfering with your life, you may
have to take your medication for a long time. As time passes, the idea
of taking your prescription only once a month instead of several times
a day may become more and more appealing.
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The body absorbs medication much more efficiently from muscle
than through the digestive system. As a result, the total amount of medication
you receive over one month is less than what you would need to control
symptoms with tablets.
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Since your body has to deal with a smaller dose of medication,
the risk of certain side effects like stiffness or shaking should be lower.
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Because depot injections deliver medication to the body in
such a consistent and efficient manner, they also lower your risk of again
suffering through the kind of severe symptoms that require hospitalization.
A simple change in medication routine may allow you a better chance of
staying out of the hospital.
PROBABLE HEALTH CONSEQUENCES OF NOT
TAKING THIS MEDICATION
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If you elect not to take this medication, it is important
for you to understand the potential consequences. The symptoms of psychosis
will not get better; in fact, they could worsen.
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When suffering from the symptoms of psychosis, you may "hear
voices" or have strange and untrue ideas. You may get excited for no apparent
reason, or spend a lot of time off by yourself, or in bed, sleeping during
the day and staying awake at night. You may neglect your appearance, and
may become difficult to communicate with--saying things that make no sense,
or barely talking at all.
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These symptoms may lead to difficulty with your job, or relationships
with your family and friends, or day-to-day functioning.
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Left untreated, psychosis also could lead to thoughts or
attempts of harming oneself or others.
ALTERNATIVE TREATMENTS
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Oral typical antipsychotic medications.
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Other antipsychotic medications ("atypical neuroleptics")
such as clozapine or risperidone.
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Electroconvulsive therapy.
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Support groups, as an adjunct to medication, are often helpful
in providing support, education, and guidance.
PROPER USE OF THIS MEDICATION
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It is important that you do not miss a clinic appointment
to receive your depot injection of medication. A consistent amount of medication
must be maintained in your body for you to continue to receive the benefits.
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If you must miss an appointment, please contact the clinic
or your physician to reschedule your appointment.
SIDE EFFECTS
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Most side effects of antipsychotic medications are mild.
Many common side effects disappear after the first few weeks of treatment.
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Drowsiness--this is usually a problem only during
the first few days when you start taking the medication. If this is a problem,
be very cautious if driving or performing tasks that require alertness
or coordination.
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Dry mouth--for temporary relief, use sugarless gum
or candy, melt bits of ice in your mouth, or use saliva substitute.
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Blurred vision--this is temporary and usually goes
away with continued use of the medication. If it becomes severe, notify
your physician.
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Dizziness--may occur when you get up too quickly or
change positions rapidly. This can be avoided by rising or changing positions
slowly.
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Difficulty in passing urine--if this becomes a problem
and continues, notify your physician.
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Weight gain--may occur in some patients while taking
this medication. If this is not desired, exercise and dietary restriction
may be helpful.
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Decreased sexual ability or interest--if this is especially
troublesome, it should be discussed with your doctor, who may prescribe
a different medication, change the dosage level or schedule, or prescribe
an additional medication to control the side effect.
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Movement difficulties--including muscle spasms
of the neck, eyes, back or other muscles; restlessness and pacing; a general
slowing down of movement and speech; and a shuffling walk. These side
effects can be treated with additional medication. If they persist or get
worse, contact your physician.
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Neurological effects--patients receiving maintenance
treatment medication, continued as a low dosage, may have the possibility
of developing long-term side effects, particularly a condition called tardive
dyskinesia. This condition is characterized by involuntary movements,
most often around the mouth, but are sometimes in areas such as trunk,
pelvis or diaphragm. For some people, this can be reversed, while others
recover partially. Your doctor will monitor your medications very carefully
to be certain you are on the lowest effective dose to decrease the risk
of this side effect developing.
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Neuroleptic Malignancy Syndrome--a rare but potentially
fatal side effect that has occurred with antipsychotic medications. Symptoms
includes very high fever, muscle stiffness and confusion, irregular heartbeat
and sweating. If these symptoms occur seek immediate medical attention.
Individuals who have had a heatstroke may be at greater risk for this condition.
PRECAUTIONS
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Do not drink alcoholic beverages while taking antipsychotics.
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Do not stop taking this medication before checking with your
doctor. Because people respond to medicines in very individual ways, you
and your physician may have to go through a trial period to find the right
drug and dosage that work best for you.
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Before taking this medication, tell your physician what prescription
and non-prescription medications you are taking (or have taken recently).
Do not begin taking prescription or non-prescription medication without
consulting your physician.
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Female patients: notify your doctor if you think you are
pregnant, if you want to become pregnant, or if you are breastfeeding while
taking this medication.
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Avoid direct exposure to sunlight while on this medication,
because this medication may cause your skin to be more sensitive to sunlight
than it is normally. If you must be out in the sun, wear protective clothing,
including a hat, and sunglasses. Apply a sun block product that has a skin
protection factor (SPF) of at least 15.
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This medication will often make you sweat less, causing your
body temperature to increase. Use extra care not to become overheated during
exercise or hot weather while you are taking this medicine, since overheating
may result in heat stroke.
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Smoking increases the metabolism of this medication leading
to unpredictable or diminished drug effects. It is best not to smoke; but
if you do smoke, frequent monitoring of the medications clinical effects
is necessary.
PHYSICIAN INFORMATION
If you have questions or concerns regarding this medication,
your physician may be reached at one of the following locations:
University Hospital
Psychiatric Unit
4502 Medical Drive
San Antonio, TX 78229
(210) 358-1260
University Health Center Downtown
Psychiatry Services - West Annex
1115 West Martin
San Antonio, TX 78207
(210) 358-3730
PHARMACY INFORMATION
A pharmacist is also available to answer questions about
your medication, and your prescription for this medication may be refilled
at the following locations:
University Hospital Outpatient Pharmacy
4502 Medical Drive
San Antonio, TX 78229
Pharmacist Line: (210) 358-2905
Refill Line: (210) 358-4186
Outpatient Pharmacy Hours:
Monday thru Friday 9:00 a.m. to 8:00 p.m.
Weekend & Holidays: 9:00 a.m. to 5:00 p.m.
University Health Center Downtown Pharmacy
527 N. Leona St.
San Antonio, TX 78207
Pharmacist Line: (210) 358-3466
Refill Line: (210) 358-3476
Pharmacy Hours:
Monday thru Friday: 8:00 a.m. to 8:00 p.m.
Saturday 8:30 a.m. – 4:00 p.m.
Sundays and Holidays: Closed
University Family Health Center, Southeast Pharmacy
3819 S. Gevers
San Antonio, TX 78223
Pharmacist Line: (210) 358-5534
Refill Line: (210) 358-5535
Pharmacy Hours:
Monday thru Thursday 8:30 a.m.-7:00 p.m.
Fridays: 8:30 a.m.- 5:00 p.m.
Saturdays: 8:00 a.m. – 12:00 p.m.
Sundays and Holidays: Closed
University Family Health Center, Southwest Pharmacy
2121 SW 36th St.
San Antonio, TX 78237
Pharmacist Line: (210) 358-5137
Refill Line: (210) 358-5138
Pharmacy Hours:
Monday thru Thursday: 8:30 a.m. – 5:30 p.m.
Fridays: 8:30 a.m. through 5:00 p.m.
Weekends and Holidays: Closed
FOR ALL REFILLS
PLEASE CALL REFILL LINE 24 HOURS
IN ADVANCE. ALLOW 1 BUSINESS DAY (M-F) FOR REFILLS.
PLEASE BE PREPARED TO PROVIDE YOUR NAME, PHONE NUMBER,
HEALTH SYSTEM I.D. NUMBER, AND Rx NUMBERS (S).