Loxitane (loxapine) has been used for many years to reduce agitation in restless patients. The medication was first developed as a treatment for schizophrenia. It belongs to the category of drugs known as typical antipsychotics. The introduction of the atypical antipsychotics in the last twenty years has led to a reduction in the use of Loxitane for its original purpose. However, medical practitioners are often finding new uses for older drugs.
A clinical trial in France will provide data on the usefulness of Loxitane for patients on mechanical ventilators. In emergency situations, ventilation is necessary to maintain a clear airway, deliver anesthesia, or protect the lungs and throat. But ventilation also comes with risks: bruising or bleeding in the airway is possible when the tube isn’t well positioned; the voice box can be damaged, as well as the thyroid gland; and damage to the lung could lead to lung collapse. These risks are magnified the longer a person stays connected to a breathing machine. Traditionally, doctors have treated restlessness during weaning with anti-anxiety drugs like Valium. The downside to this approach is that the person becomes too sedated to continue the weaning process. Re-sedation also adds to the risk of complications.
Researchers will give eligible patients up to 900 mg of Loxitane each day, for up to 14 days. A control group will receive an equal quantity of placebo. The time to successful weaning from mechanical ventilation will be compared between the two groups. For the purposes of the study, successful weaning is defined as unassisted breathing for at least 48 hours after tube removal. Researchers will monitor each participant for adverse effects or unexpected biological responses, and any potential safety issues will be addressed. Patients displaying extreme restlessness, for example, will not participate in the study.
Mechanical intubation is a life-saving practice, but it’s not without risks. It’s in the patient’s best interests that the tube be removed and free breathing restored as soon as possible. Agitation and confusion often make this transition difficult and dangerous—injury is a real concern anytime someone is being weaned from artificial breathing. The French research team hopes that Loxitane will be an effective solution for patient restlessness during the mechanical ventilation weaning process.
- Endotracheal intubation: MedlinePlus Medical Encyclopedia. (n.d.). National Library of Medicine – National Institutes of Health. Retrieved August 24, 2012, from http://www.nlm.nih.gov/medlineplus/ency/article/003449.htm
- Loxapine – PubMed Health. (n.d.). National Center for Biotechnology Information. Retrieved August 24, 2012, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000645/
- Loxapine in the Management of Restlessness During Mechanical Ventilation Weaning. (n.d.). ClinicalTrials.gov. Retrieved August 24, 2012, from http://clinicaltrials.gov/ct2/show/NCT01193816?recr=Open&intr=%22Loxapine%22&rank=1
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