Thiothixene

NAVANE

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Pronunciation: thye-oe-THIX-een

Thiothixene ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Thiothixene ballicule

Thiothixene NAVANE mascot mnemonic cartoon — Visual mnemonic: Thiothixene mascot
**“Thighs thick to Navel”**
spooky mascot in greyscale → high potency first-gen antipsychotic

What it isD2-predominant thioxanthene antipsychotic; schizophrenia.

Why this oneIts niche is an inexpensive oral typical with less sedation and antimuscarinic toxicity than low-potency agents, but no depot form.

What limits itAkathisia, parkinsonism, and tardive dyskinesia commonly limit use; QT prolongation and NMS remain serious risks.

Thiothixene molecular structure (skeletal formula) — Molecular structure: Thiothixene

FDA-approved for

schizophrenia (~1967)

FDA label

Read the full label on DailyMed ↗

BOXED WARNING Increased mortality in elderly patients with dementia-related psychosis treated with antipsychotics; not approved for dementia-related psychosis.

FDA dosing	Population	Start	Target	Max
Schizophrenia (milder)	Adults	2 mg TID	15 mg/day	60 mg/day
Schizophrenia (more severe)	Adults	5 mg BID	20-30 mg/day	60 mg/day

Renal Undefined

Hepatic Undefined

Exceeding 60 mg/day rarely increases benefit

Instructions

Individualize dose; start small and increase gradually to optimal effect
Some patients maintained on once-daily dosing
Not recommended in children under 12 years

Available strengths

cap 1, 2, 5, 10 mg

Contraindications

Circulatory collapse
Comatose states or CNS depression due to any cause
Blood dyscrasias

Cautions

Tardive dyskinesia with long-term use
Neuroleptic malignant syndrome (NMS)
Extrapyramidal symptoms and dystonia, especially early and at higher doses
Orthostatic hypotension/syncope (do not use epinephrine as pressor)
Seizures; sedation

Adverse reactions

Tachycardia, hypotension, lightheadedness, syncope
Drowsiness, restlessness, agitation, insomnia
Extrapyramidal symptoms, dystonia, tardive dyskinesia
Dry mouth, blurred vision, constipation
Hyperprolactinemia, menstrual irregularities

Pregnancy Undefined

Lactation Undefined

Cost

Thiothixene (NAVANE)

What pharmacies pay · NADAC 9/30/26

Strength		#/mo	generic $/mo	CostPlus
1 mg	cap	90 TID	$58.79	offered
2 mg	cap	90 TID	$68.87	offered
5 mg	cap	90 TID	$125.06	offered
10 mg	cap	90 TID	$154.49	offered

Generic entry1987

⚠ BOXED WARNING

Increased mortality in elderly patients with dementia-related psychosis

Classes and tags

Clinical profile

Therapeutic safety burden2 / 4

Overdose danger2 / 4

Weight-gain liability1 / 4

Sedation liability1 / 4

QT / Torsades2 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk2 / 4

Legacy pregnancy categoryC

Defining liabilityMetabolic effects, extrapyramidal symptoms/tardive dyskinesia and agent-specific QT or orthostatic risk.

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Memory aids: interaction avatars

CYP1A2 substrate

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