People with schizophrenia or other mental health problems often hear disturbing voices or see distressing things (which are called delusions, hallucinations and psychosis). Such experiences can be frightening and may lead people to be aggressive or show violent behaviour toward themselves or other people. Tranquilising drugs are medications that help people to sleep or calm down, and help stop aggressive or disorganised behaviour. An antipsychotic effect is also desirable to help stop the delusions and hallucinations. Tranquillisers should not have to be used often and also have few unwanted side-effects, such as pain at the injection site or uncontrolled shaking of the head and hands. Zuclopenthixol acetate is said to possess all these properties.
Zuclopenthixol acetate is given by an injection and has an effect that lasts for about two to three days. This review looks at zuclopenthixol acetate for managing aggression or violence. The review did not find any evidence that zuclopenthixol acetate is more or less effective in helping to control aggression or violence, or in preventing unwanted side-effects than other drugs (such as haloperidol, chlorpromazine, clothiapine). It did not seem to work quickly and/or be rapid in calming people down.
Zuclopenthixol acetate may result in less forced injections (where restraint of the patient is needed to enable treatment). Low doses of the drug (as low as 25 mg) may be just as good and effective as higher doses (up to 100 mg).
Overall the review found limited information for claims made to support the use of this drug (for example: that it rapidly calms or sedates people; or that it is better than other drugs in emergency situations). Recommendations on the use of zuclopenthixol acetate for aggressive or violent behaviour therefore have to be viewed with caution.
Evidence is very far from good and convincing. Most of the research on the subject is small in size, with few participants, of short duration and data poorly reported in the individual studies. But it does point to zuclopenthixol acetate being helpful for managing very disturbed people. In comparison to other drugs it is not any worse than others. Moreover, the whole area on the management of very disturbed people is under-researched and more research is necessary.
This Plain Language Summary has been written by a consumer: Benjamin Gray, Service User and Service User Expert, Rethink Mental Illness, Email: ben.gray@rethink.org .