Deanxit (also marketed under names like Mocalm in Taiwan) is a combination medication that contains two active ingredients: Flupentixol (0.5 mg) + Melitracen (10 mg) per tablet.
Here’s a breakdown of what it’s used for, how it works, and what the caveats are. This is not medical advice; for your personal situation, you should consult your psychiatrist or other treating clinician.
✅ What good does Deanxit / Mocalm do?
Indications / uses
- The medication is indicated for anxiety and depression, especially when symptoms are combined (for example: depressed mood + anxiety/restlessness). According to the product leaflet: “used to treat anxiety and depression in patients with or without psychosomatic symptoms.”
- In Taiwan, the label for Mocalm lists the active substances and its indication code: “AC46759100”; the indication is the same combination Flupentixol/Melitracen.
- The mechanism: Flupentixol is a thioxanthene antipsychotic with mild anxiolytic and antidepressant effects at low doses. Melitracen is a tricyclic antidepressant (TCA) which helps boost mood by increasing neurotransmitters such as serotonin and norepinephrine.
- So together, the combination gives antidepressant + anxiolytic + mood-elevating/activating properties. From the leaflet: “in combination the active substances render a preparation with antidepressant, anxiolytic and activating properties.”
How it may help
- If someone is experiencing mild to moderate depression with significant anxiety or restlessness, this combination may help by addressing both mood and anxiety components.
- The “activating” component means it might help when depression is accompanied by low energy/amotivation and anxiety (rather than pure “low mood” with low activation).
- Because of the low dose of the antipsychotic (flupentixol 0.5 mg), the side‐effect burden may be less than some high‐dose antipsychotics, though side‐effects still exist (see below).
- In regions where it’s approved, it may offer a combined therapy in one pill rather than separate antidepressant + anxiolytic/antipsychotic.
⚠️ Important caveats, limitations & safety considerations
- Evidence base: Although the combination is used in many countries, its evidence base (especially via large randomized controlled trials) may not be as robust or as standard in some guidelines compared with SSRIs/SNRIs or other first-line antidepressants. For example, the Wikipedia article flags that “lack of required information such as mandatory clinical trial results” led to its removal from approval lists in some countries.
- Not suitable for severe depression requiring hospitalisation: The leaflet specifically states that Deanxit is “not suitable for patients with severe depression … who may require hospitalisation or electroconvulsive therapy (ECT)”.
- Typical dosing & regimen: As per the leaflet, for adults: usually 2 tablets per day (one in morning and one at noon). In more severe cases dose may increase to 2 in morning + 1 at noon. Maintenance often is 1 tablet in the morning.
- Side effects & risks: The usual caution for antipsychotics and TCAs apply. Some side effects: extrapyramidal symptoms (especially from flupentixol), sedation/drowsiness, anticholinergic effects (from melitracen), cardiovascular risks (QT prolongation, arrhythmias) especially in TCA/antipsychotic combinations. The leaflet mentions: “disturbances in heart rhythm … The medicine is contraindicated if you have disturbances in heart rhythm…”
- Special populations: Not recommended in children/adolescents (lack of data) and use in pregnancy or breastfeeding requires caution.
- Duration of use: Typically short to medium term; long‐term use should be regularly reviewed by clinician. As one source states: “Deanxit is generally prescribed for short to medium-term use. Long-term use should be regularly reviewed by a healthcare provider.”
- Contraindications & interactions: The leaflet lists many: e.g., heart disease, arrhythmias, taking MAO‐inhibitors, glaucoma, urinary retention, hyperthyroidism, liver/renal disease.
🧭 My viewpoint: When it might be a “good” choice
Given all of the above, here’s when I think the combination could be a reasonable choice, and when you might want to consider alternatives.
Could be reasonable when:
- The patient has moderate depression with anxiety/restlessness (rather than pure melancholic low-mood) and where boosting activation is helpful.
- First-line antidepressants (like SSRIs) either weren’t tolerated or didn’t give full relief, and you want a combination pill approach.
- The treating clinician has experience with the drug and monitors side-effects carefully (given the TCA + antipsychotic combo).
- The severity doesn’t require hospitalisation, ECT, or immediate intervention for high suicide risk/psychosis.
Might not be the best choice when:
- The depression is severe (psychotic features, suicidal intent) — then more evidence‐based interventions are needed.
- There are significant medical comorbidities (heart disease, arrhythmias, glaucoma) which increase risk of antipsychotics or TCAs.
- The patient has bipolar disorder (because the combination is not primarily a mood‐stabiliser or mania‐prevention drug) unless a mood stabiliser is also used.
- There is a need for long-term maintenance where a more established antidepressant/maintenance regime might be preferred.
- The patient is pregnant or breastfeeding without strong indication and clinician supervision.
If you like, I can check clinical trial data specifically for flupentixol/melitracen (Deanxit/Mocalm) in the Taiwanese context (efficacy, safety, practice patterns) and also check regulatory status in Taiwan (whether it’s approved, any restrictions). Would you like me to do that?
