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Last Updated: December 16, 2025

CLINICAL TRIALS PROFILE FOR CHLORPROTHIXENE


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All Clinical Trials for CHLORPROTHIXENE

Trial ID Title Status Sponsor Phase Start Date Summary
NCT01309178 ↗ Anti-inflammatory Pulmonal Therapy of Cystic Fibrosis (CF) Patients With Amitriptyline and Placebo Unknown status Universität Duisburg-Essen Phase 2 2009-05-01 Cystic fibrosis patients suffer from a chronic destruction of the lung, frequent and finally chronic pneumonia and a reduced life expectancy. Unfortunately, no curative treatment for cystic fibrosis is available, neither are treatments established that prevent the disease. Our data identify ceramide as a potential novel target to treat cystic fibrosis. Two smaller trials support the notion that inhibition of the acid sphingomyelinase by amitriptyline improves the lung function of CF-patients even at a dose that is low enough to avoid adverse effects. In the present proposal the investigators, therefore, aim to test in a larger cystic fibrosis patient population whether an inhibition of ceramide release in the lung caused by the lack of functional CFTR improves the lung function of cystic fibrosis patients. Inhibition of ceramide-release in the lung will be achieved by treatment with amitriptyline, which is used as an anti-depressant drug for almost 50 years. Although it is not absolutely specific, it seems to be relatively specific for the degradation of acid sphingomyelinase (typically 60-80% of cellular acid sphingomyelinase are degraded), which releases ceramide from sphingomyelin. If the data confirm the beneficial effect of amitriptyline already observed in our preliminary studies, the present clinical study may establish a novel treatment to improve clinical symptoms of cystic fibrosis and, moreover, to prevent or at least delay the onset of cystic fibrosis. Hypothesis - Amitriptyline reduces ceramide concentrations in respiratory epithelial cells (measured in nasal epithelial cells obtained by brushing nasal mucosa). - Amitriptyline treatment reduces cell death in bronchi and deposition of DNA on the respiratory epithelium, which permits elimination of P. aeruginosa from the lung (measured as P. aeruginosa counts in tracheal fluid). - Amitriptyline treatment results in normalization of the function of leukocytes (number determined in serum and tracheal fluid) - Amitriptyline reduces systemic and local inflammation (measured as cytokines in plasma and tracheal fluid). Based on these effects amitriptyline increases the lung function of cystic fibrosis patients (measured by FEV1).
NCT01309178 ↗ Anti-inflammatory Pulmonal Therapy of Cystic Fibrosis (CF) Patients With Amitriptyline and Placebo Unknown status University of Ulm Phase 2 2009-05-01 Cystic fibrosis patients suffer from a chronic destruction of the lung, frequent and finally chronic pneumonia and a reduced life expectancy. Unfortunately, no curative treatment for cystic fibrosis is available, neither are treatments established that prevent the disease. Our data identify ceramide as a potential novel target to treat cystic fibrosis. Two smaller trials support the notion that inhibition of the acid sphingomyelinase by amitriptyline improves the lung function of CF-patients even at a dose that is low enough to avoid adverse effects. In the present proposal the investigators, therefore, aim to test in a larger cystic fibrosis patient population whether an inhibition of ceramide release in the lung caused by the lack of functional CFTR improves the lung function of cystic fibrosis patients. Inhibition of ceramide-release in the lung will be achieved by treatment with amitriptyline, which is used as an anti-depressant drug for almost 50 years. Although it is not absolutely specific, it seems to be relatively specific for the degradation of acid sphingomyelinase (typically 60-80% of cellular acid sphingomyelinase are degraded), which releases ceramide from sphingomyelin. If the data confirm the beneficial effect of amitriptyline already observed in our preliminary studies, the present clinical study may establish a novel treatment to improve clinical symptoms of cystic fibrosis and, moreover, to prevent or at least delay the onset of cystic fibrosis. Hypothesis - Amitriptyline reduces ceramide concentrations in respiratory epithelial cells (measured in nasal epithelial cells obtained by brushing nasal mucosa). - Amitriptyline treatment reduces cell death in bronchi and deposition of DNA on the respiratory epithelium, which permits elimination of P. aeruginosa from the lung (measured as P. aeruginosa counts in tracheal fluid). - Amitriptyline treatment results in normalization of the function of leukocytes (number determined in serum and tracheal fluid) - Amitriptyline reduces systemic and local inflammation (measured as cytokines in plasma and tracheal fluid). Based on these effects amitriptyline increases the lung function of cystic fibrosis patients (measured by FEV1).
NCT01309178 ↗ Anti-inflammatory Pulmonal Therapy of Cystic Fibrosis (CF) Patients With Amitriptyline and Placebo Unknown status University Children's Hospital Tuebingen Phase 2 2009-05-01 Cystic fibrosis patients suffer from a chronic destruction of the lung, frequent and finally chronic pneumonia and a reduced life expectancy. Unfortunately, no curative treatment for cystic fibrosis is available, neither are treatments established that prevent the disease. Our data identify ceramide as a potential novel target to treat cystic fibrosis. Two smaller trials support the notion that inhibition of the acid sphingomyelinase by amitriptyline improves the lung function of CF-patients even at a dose that is low enough to avoid adverse effects. In the present proposal the investigators, therefore, aim to test in a larger cystic fibrosis patient population whether an inhibition of ceramide release in the lung caused by the lack of functional CFTR improves the lung function of cystic fibrosis patients. Inhibition of ceramide-release in the lung will be achieved by treatment with amitriptyline, which is used as an anti-depressant drug for almost 50 years. Although it is not absolutely specific, it seems to be relatively specific for the degradation of acid sphingomyelinase (typically 60-80% of cellular acid sphingomyelinase are degraded), which releases ceramide from sphingomyelin. If the data confirm the beneficial effect of amitriptyline already observed in our preliminary studies, the present clinical study may establish a novel treatment to improve clinical symptoms of cystic fibrosis and, moreover, to prevent or at least delay the onset of cystic fibrosis. Hypothesis - Amitriptyline reduces ceramide concentrations in respiratory epithelial cells (measured in nasal epithelial cells obtained by brushing nasal mucosa). - Amitriptyline treatment reduces cell death in bronchi and deposition of DNA on the respiratory epithelium, which permits elimination of P. aeruginosa from the lung (measured as P. aeruginosa counts in tracheal fluid). - Amitriptyline treatment results in normalization of the function of leukocytes (number determined in serum and tracheal fluid) - Amitriptyline reduces systemic and local inflammation (measured as cytokines in plasma and tracheal fluid). Based on these effects amitriptyline increases the lung function of cystic fibrosis patients (measured by FEV1).
NCT01309178 ↗ Anti-inflammatory Pulmonal Therapy of Cystic Fibrosis (CF) Patients With Amitriptyline and Placebo Unknown status University Children’s Hospital Tuebingen Phase 2 2009-05-01 Cystic fibrosis patients suffer from a chronic destruction of the lung, frequent and finally chronic pneumonia and a reduced life expectancy. Unfortunately, no curative treatment for cystic fibrosis is available, neither are treatments established that prevent the disease. Our data identify ceramide as a potential novel target to treat cystic fibrosis. Two smaller trials support the notion that inhibition of the acid sphingomyelinase by amitriptyline improves the lung function of CF-patients even at a dose that is low enough to avoid adverse effects. In the present proposal the investigators, therefore, aim to test in a larger cystic fibrosis patient population whether an inhibition of ceramide release in the lung caused by the lack of functional CFTR improves the lung function of cystic fibrosis patients. Inhibition of ceramide-release in the lung will be achieved by treatment with amitriptyline, which is used as an anti-depressant drug for almost 50 years. Although it is not absolutely specific, it seems to be relatively specific for the degradation of acid sphingomyelinase (typically 60-80% of cellular acid sphingomyelinase are degraded), which releases ceramide from sphingomyelin. If the data confirm the beneficial effect of amitriptyline already observed in our preliminary studies, the present clinical study may establish a novel treatment to improve clinical symptoms of cystic fibrosis and, moreover, to prevent or at least delay the onset of cystic fibrosis. Hypothesis - Amitriptyline reduces ceramide concentrations in respiratory epithelial cells (measured in nasal epithelial cells obtained by brushing nasal mucosa). - Amitriptyline treatment reduces cell death in bronchi and deposition of DNA on the respiratory epithelium, which permits elimination of P. aeruginosa from the lung (measured as P. aeruginosa counts in tracheal fluid). - Amitriptyline treatment results in normalization of the function of leukocytes (number determined in serum and tracheal fluid) - Amitriptyline reduces systemic and local inflammation (measured as cytokines in plasma and tracheal fluid). Based on these effects amitriptyline increases the lung function of cystic fibrosis patients (measured by FEV1).
NCT02374567 ↗ Pharmacovigilance in Gerontopsychiatric Patients Terminated Hannover Medical School Phase 3 2015-01-01 The purpose of this multicenter-study is to investigate safety of psychopharmacological treatment and rates of adverse drug reactions in gerontopsychiatric inpatients. Elderly people are at higher risk for developing side effects under pharmacological treatment due to an altered metabolic situation, higher comorbidity rates and often polypharmacy. Furthermore gerontopsychiatric patients can often not articulate their symptoms clearly, for example due to pronounced cognitive impairment. The aim of the study is to gain valid data of possible adverse drug reaction rates, their potential risk factors and outcome, as well as medical prescription practises. To assess these outcomes an intensive pharmacovigilance-monitoring will be conducted at the five participating study sites. At Baseline demographic data, previous and present disorders, use of drugs, previous and present medication, quality of life, cognitive function, physical examination results, laboratory results and ECG will be assessed. Afterwards patients are visited weekly and screened for possible adverse drug reactions. All adverse drug reactions will be coded in the MedDRA-system. In case of a possible serious adverse drug reaction serum levels of all psychotropic substances applicated will be assessed. Drug combinations will be analysed using an established advanced bioinformatic tool (mediQ). Diagnosis, medication intake and possible adverse drug reactions are documented continually. 2 weeks after discharge from the ward, patients will be contacted by phone to assess catamnestic data.
NCT02582736 ↗ Antipsychotics and Risk of Hyperglycemic Emergencies Completed Canadian Institutes of Health Research (CIHR) 2012-04-01 The purpose of this study is to determine whether the use of atypical antipsychotic medication increases the risk of hospitalization for a hyperglycemic emergency. The investigators will carry out separate population-based cohort studies using administrative health databases in eight jurisdictions in Canada and the UK. Cohort entry will be defined by the initiation of a new antipsychotic medication. Follow-up will continue until hospitalization for a hyperglycemic emergency or the end of 365 days. The results from the separate sites will be combined to provide an overall assessment of the risk of hyperglycemic emergencies among new users of various antipsychotic drugs.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for CHLORPROTHIXENE

Condition Name

Condition Name for CHLORPROTHIXENE
Intervention Trials
Schizophrenia 2
Schizoaffective Disorder 1
Anxiety Disorders 1
Bipolar Disorder 1
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Condition MeSH

Condition MeSH for CHLORPROTHIXENE
Intervention Trials
Schizophrenia 2
Disease 2
Fibrosis 1
Mental Disorders 1
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Clinical Trial Locations for CHLORPROTHIXENE

Trials by Country

Trials by Country for CHLORPROTHIXENE
Location Trials
Germany 2
Canada 1
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Clinical Trial Progress for CHLORPROTHIXENE

Clinical Trial Phase

Clinical Trial Phase for CHLORPROTHIXENE
Clinical Trial Phase Trials
Phase 3 1
Phase 2 1
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Clinical Trial Status

Clinical Trial Status for CHLORPROTHIXENE
Clinical Trial Phase Trials
Completed 1
Terminated 1
Unknown status 1
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Clinical Trial Sponsors for CHLORPROTHIXENE

Sponsor Name

Sponsor Name for CHLORPROTHIXENE
Sponsor Trials
Universität Duisburg-Essen 1
University of Ulm 1
University Children's Hospital Tuebingen 1
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Sponsor Type

Sponsor Type for CHLORPROTHIXENE
Sponsor Trials
Other 8
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Clinical Trials Update, Market Analysis, and Projection for Chlorprothixene

Last updated: November 3, 2025

Introduction

Chlorprothixene, a first-generation antipsychotic belonging to the thioxanthene class, has historically served as a treatment for schizophrenia, anxiety, and agitation. Its pharmacological profile involves dopamine receptor antagonism, which underpins its antipsychotic effects. Despite its long-standing clinical presence, chlorprothixene’s recent trajectory reflects shifts driven by evolving psychiatric treatment paradigms, regulatory landscapes, and patent landscapes. This article delivers an exhaustive review of current clinical trials, conducts a market analysis, and projects future market potential for chlorprothixene.


Clinical Trials Landscape for Chlorprothixene

Current Status of Clinical Trials

As of late 2023, the clinical trial activity for chlorprothixene remains limited, largely confined to traditional formulations and retrospective analyses rather than ongoing large-scale trials. The ClinicalTrials.gov database records a handful of studies, primarily focusing on safety, tolerability, and pharmacokinetics in specific populations, such as elderly patients with schizophrenia or agitation [1].

Notably, there are no recent phase III or phase IV trials indicating active development for new indications or reformulations within the last five years. This stagnation highlights a diminished R&D interest, attributable to the emergence of atypical antipsychotics with improved side effect profiles and ongoing patent expirations of older drugs.

Historical and Retrospective Data

Historically, chlorprothixene was widely used in Europe and some other markets, but its use has declined significantly. Existing clinical trials evaluated its efficacy mainly in the mid-20th century. Recent retrospective studies analyze its long-term safety profile and comparative effectiveness relative to newer agents [2].

Potential for Future Trials

Given the growing emphasis on niche psychiatric treatments and polypharmacy approaches, there exists an unmet need for cost-effective, well-tolerated antipsychotics. Some academic institutions are exploring chlorprothixene’s potential for off-label use or combination therapy, but regulatory and commercial incentives remain limited.


Market Analysis

Historical Market Dynamics

The global antipsychotic market reached approximately $14 billion USD in 2022, dominated by second-generation (atypical) antipsychotics such as risperidone, olanzapine, and aripiprazole [3]. Chlorprothixene's market share has waned sharply, primarily remaining in legacy markets like certain European countries and parts of Asia, where older medications sustain clinical use.

Market Players and Competitors

The market for traditional antipsychotics is now highly consolidated, with leading global pharmaceutical giants focusing on newer agents. Chlorprothixene's principal competitors include phenothiazines like chlorpromazine and other thioxanthene compounds. These newer agents often boast improved tolerability profiles, which has led to declining use of chlorprothixene, especially in Western markets.

Regulatory and Patent Status

Chlorprothixene's patent protections expired decades ago, reducing barriers for generic manufacturing. This commoditization constrains pricing power and R&D investment. Regulatory environments in developed countries have shifted focus toward drugs with better safety profiles, further limiting chlorprothixene’s upward market trajectory.

Regional Market Opportunities

  • Emerging Markets: Countries such as India, China, and parts of Southeast Asia still utilize older antipsychotics due to cost considerations, regulatory acceptance, and existing prescriber familiarity.
  • Niche Applications: Some clinicians prefer chlorprothixene for sedation in psychiatric or non-psychiatric settings, which sustains minor demand.

Market Forecasts (2024–2030)

Given the current landscape, overall market growth for chlorprothixene remains stagnant. However, localized niche markets and aging populations with treatment-resistant conditions may sustain modest demand. The global market for traditional antipsychotics is projected to decline at a CAGR of around 1.2% over the next six years, with specialist markets maintaining marginal stability or slight growth due to cost-sensitive healthcare settings.

In contrast, the broader antipsychotic market, driven by newer agents, is projected to grow at approximately 4.5% CAGR, reaching an estimated $21 billion USD by 2030 [3].


Future Market Projection and Strategic Outlook

Market Viability

Chlorprothixene’s future commercial viability hinges on niche applications, price competitiveness, and local regulatory acceptance. Without significant formulation improvements or new indications, its role is likely to diminish further in developed markets, where safety concerns favor newer drugs.

Potential for New Formulations or Indications

Innovative formulation strategies, such as sustained-release variants or combining chlorprothixene with adjunct therapies, could carve out niche markets. However, substantial investments are unlikely given the current patent and market dynamics.

Regulatory Considerations

Market rehabilitation would require new clinical data emphasizing safety, especially in elderly or polypharmacy populations. Regulatory agencies may impose stricter safety evaluations, and the lack of current R&D momentum hampers efforts to innovate.

Strategic Recommendations

  • Focus on Cost-Sensitive Markets: Target regions with limited access to newer atypicals.
  • Explore Off-Label and Adjunct Uses: Leverage existing safety data to promote niche applications.
  • Collaborate with Generic Manufacturers: Ensure steady supply and optimize pricing.
  • Monitor Emerging Evidence: Stay alert to academic research that may rediscover chlorprothixene’s potential.

Key Takeaways

  • Limited Clinical Development: Active clinical trials for chlorprothixene are minimal, with recent activity primarily retrospective or safety-focused.
  • Declining Market Share: Chlorprothixene's global market share continues to decline amid competition from newer, better-tolerated antipsychotics.
  • Localized Niche Markets: It maintains modest demand in emerging markets and specific clinical niches due to cost advantages.
  • Market Growth Prospects: Overall landscape suggests a stagnant to slightly declining trend, with some regional opportunities.
  • Strategic Focus: Opportunities lie in targeted markets, generic supply reliability, and exploring off-label or adjunct uses, but substantial growth prospects are limited.

FAQs

Q1: Is there ongoing research to develop new formulations of chlorprothixene?
A: No significant ongoing research focuses on reformulating chlorprothixene. Most efforts in antipsychotic development are geared toward newer agents with improved safety profiles.

Q2: What are the primary safety concerns associated with chlorprothixene?
A: Common issues include sedation, extrapyramidal symptoms, and anticholinergic effects. Elderly populations are at increased risk for adverse effects such as tardive dyskinesia and cognitive impairment.

Q3: Can chlorprothixene be considered a cost-effective treatment option?
A: In resource-limited settings, chlorprothixene remains a cost-effective choice due to generic availability, despite its side effect profile and declining clinical use.

Q4: Are there any emerging indications for chlorprothixene?
A: Currently, no novel indications are being actively explored. Its primary use remains in psychiatric conditions like schizophrenia and agitation.

Q5: What factors could potentially revive interest in chlorprothixene?
A: Discovery of distinct pharmacological benefits, a major safety advantage over current therapies, or novel delivery systems could spark renewed interest, but these are unlikely given current developments.


References

[1] ClinicalTrials.gov. (2023). Search results for "chlorprothixene".
[2] Katz, R. (2010). Safety profile of first-generation antipsychotics: chlorprothixene. Journal of Clinical Psychiatry.
[3] MarketWatch. (2023). Global antipsychotic drugs market analysis and forecasts.


In conclusion, chlorprothixene’s current landscape remains characterized by aging formulations and niche regional use, with limited clinical development and declining market relevance. Its role in psychiatry is predominantly historical, with future prospects confined to specific, cost-conscious regional markets unless unforeseen therapeutic innovations emerge.

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