Molindone

Molindone, or molindone hydrochloride, belongs to a class of drugs called typical antipsychotics. It’s used to treat the symptoms of schizophrenia, such as hallucinations, nervousness, and aggression. Molindone should be taken by strictly following doctor’s orders as it poses potential interactions with other substances and presents the risk of numerous adverse effects, some of which can be severe.

Molindone brand names

Molidone was sold under the brand name Moban, but it is no longer available under that name.^[1] Other generic forms of the drug might be available. However, second-generation or atypical antipsychotics are preferred instead of molindone because of fewer associated side effects.

What is molindone prescribed for?

Molindone is prescribed to treat psychosis, primarily as seen in schizophrenia. It is particularly effective in reducing the occurrence of hallucinations and delusions.

How does molindone work?

Molindone hydrochloride is rapidly absorbed in the gastrointestinal tract. It works on dopamine, a neurotransmitter in the brain responsible for feelings of satisfaction, pleasure, and motivation.^[2] However, the precise mechanism of action has yet to be entirely understood. Research suggests that molindone binds with antagonizing dopamine receptors in the brain, thereby reducing dopamine activity.

As a result of this action, the physiological and psychological effects of schizophrenia, like hallucinations and delusions, can be reduced. In animal research, molindone hydrochloride has a profile not unlike a tranquilizer – it reduces hyperactivity, aggressiveness, and spontaneous movements.^[3]

How is molindone usually taken?

Molindone is taken in tablet form by mouth.^[1] The initial dosage for adults and children ages 12-18 is typically 50-75 mg daily, increasing to 100 mg daily after three to four days.

After the initial dosage, a maintenance dosage for patients with mild symptoms might be 5-15 mg three or four times a day, while those with moderate symptoms might need 10-25 mg three to four times per day. Patients with severe symptoms can take up to 225 mg of molindone daily.^[4]

How long does molindone stay in your system?

Molidone is rapidly absorbed – it takes only 30-60 minutes to reach peak concentration after a single 25 mg or lower dose. The drug has a half-life of two hours and is eliminated from the body within approximately 11 hours. Yet, within four hours, molindone is undetectable.^[5]

Molindone side effects

As noted earlier, molindone is not commonly prescribed any longer because newer antipsychotic drugs with fewer side effects are available. Nevertheless, molindone might be prescribed if first-line treatments prove unsuccessful.

Molindone side effects can be grouped into two categories: common and rare. Usually, common side effects are low-grade and don’t require medical attention. Rare side effects can be severe and even deadly.

Common molindone side effects

Molindone hydrochloride might cause mild or moderate headache, dry mouth, and drowsiness. Reports of dizziness, blurred vision, and tremor are also common.^[6]

Other typical side effects include the following:^[4]

• Elevated heart rate
• Feelings of nervousness or restlessness
• Nausea
• Constipation
• Reduced or absent need to urinate

Rare molindone side effects

Patients have sometimes experienced severe side effects when taking molindone hydrochloride. These include seizures, difficulty breathing or swallowing, and muscle tremors. Female patients might experience changes in the menstrual cycle, discharge from the nipples, and changes in the vaginal and breast areas. Male patients might have breast swelling or experience impotence.^[4]

A severe, adverse nervous system reaction to molindone is also possible. In such cases, patients can experience sweating, fever, and extremely rigid muscles, as well as tremors, a rapid or irregular heartbeat, and feeling faint. Additionally, in rare cases, patients’ white blood cell count will plummet, accompanied by difficulty breathing, mouth and skin sores, sore throat, and cough. Fever and chills might also occur.^[4]

Molindone precautions

Because molindone can exacerbate a low white blood cell count (called Leukopenia), it’s imperative that you tell your doctor if you have the condition. Similarly, it’s necessary to disclose to your physician if you have ever had breast cancer, depression, difficulties with balance, glaucoma, heart problems, or chronic constipation.

In rare cases, molindone is associated with causing shaking, muscle stiffness, difficulty eating, and sleep problems in newborns. As such, your physician needs to know if you’re pregnant, particularly in the final trimester. Similarly, if you become pregnant while taking molindone, talk to your doctor.^[1]

As with any medication, communicate with your doctor about taking molindone before having surgery, including dental surgery.

Molindone interactions

Molindone hydrochloride has not been shown to pose any clinically significant interactions with other drugs.^[6] 

Nonetheless, the potential exists for dangerous drug interactions with medications that cause drowsiness or slowed breathing. Tell your doctor if you’re taking muscle relaxers, opioids, sleeping pills, anxiolytics, or anti-epileptic drugs (especially phenytoin). Also, disclose if you’re taking any antibiotics, particularly minocycline, demeclocycline, doxycycline, or tetracycline.^[4]

As with any medication, it’s also important to tell your doctor about other substances you’re taking, like over-the-counter medicines, herbal supplements, vitamins, and the like. Also, disclose any recreational drugs you use or have used in the past.

Molindone storage

Molindone hydrochloride should be stored in its original, child-proof container away from light, heat, and moisture. Store it in a location that is out of sight and out of reach of children. It should also be stored where pets are unable to reach it.

What to do if you overdose on molindone

An overdose of molidone can lead to severe complications, including difficulty breathing or loss of consciousness. In the event of either of these situations, call 911 immediately. Otherwise, if you or someone you know suspects a molindone overdose, call the poison control hotline at 1-800-222-1222. Additional details about poisoning, including live online help, are available from America’s Poison Centers.