{{Short description|Typical antipsychotic medication}} {{cs1 config|name-list-style=vanc|display-authors=6}} {{Use dmy dates|date=March 2024}} {{Infobox drug | Watchedfields = changed | verifiedrevid = 443824001 | image = Fluphenazine.svg | image_class = skin-invert-image | width = 250 | alt = | image2 = Fluphenazine-xtal-2012-ball-and-stick.png | image_class2 = bg-transparent | width2 = 250 | alt2 =

<!--Clinical data--> | tradename = Prolixin, Modecate, Moditen others | Drugs.com = {{drugs.com|monograph|fluphenazine-decanoate}} | MedlinePlus = a682172 | DailyMedID = Fluphenazine | pregnancy_AU = C | pregnancy_category = | routes_of_administration = By mouth, Intramuscular injection, depot injection (fluphenazine decanoate) | class = Typical antipsychotic | ATC_prefix = N05 | ATC_suffix = AB02

| legal_AU = | legal_BR = C1 | legal_BR_comment = <ref>{{Cite web | vauthors = Anvisa | title = RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial | date = 31 March 2023 | trans-title = Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control | url = https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-784-de-31-de-marco-de-2023-474904992 | url-status = live | archive-url = https://web.archive.org/web/20230803143925/https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-784-de-31-de-marco-de-2023-474904992 | archive-date = 3 August 2023 | access-date = 16 August 2023 | publisher = Diário Oficial da União | language = pt-BR | publication-date = 4 April 2023 }}</ref> | legal_CA = Rx-only | legal_UK = POM | legal_US = Rx-only

<!--Pharmacokinetic data--> | bioavailability = 2.7% (by mouth) | metabolism = unclear<ref name="AHFS2015" /> | elimination_half-life = IM 15 hours (HCl), 7–10 days (decanoate)<ref name="AHFS2015" /> | excretion = Urine, feces

<!--Identifiers--> | CAS_number_Ref = {{cascite|correct|??}} | CAS_number = 69-23-8 | PubChem = 3372 | IUPHAR_ligand = 204 | DrugBank_Ref = {{drugbankcite|correct|drugbank}} | DrugBank = DB00623 | ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}} | ChemSpiderID = 3255 | UNII_Ref = {{fdacite|correct|FDA}} | UNII = S79426A41Z | KEGG_Ref = {{keggcite|correct|kegg}} | KEGG = D07977 | ChEBI_Ref = {{ebicite|correct|EBI}} | ChEBI = 5123 | ChEMBL_Ref = {{ebicite|correct|EBI}} | ChEMBL = 726

<!--Chemical data--> | IUPAC_name = 2-[4-[3-[2-(trifluoromethyl)-10''H''-phenothiazin-10-yl]propyl]piperazin-1-yl]ethanol | C=22 | H=26 | F=3 | N=3 | O=1 | S=1 | SMILES = FC(F)(F)c2cc1N(c3c(Sc1cc2)cccc3)CCCN4CCN(CCO)CC4 | StdInChI_Ref = {{stdinchicite|correct|chemspider}} | StdInChI = 1S/C22H26F3N3OS/c23-22(24,25)17-6-7-21-19(16-17)28(18-4-1-2-5-20(18)30-21)9-3-8-26-10-12-27(13-11-26)14-15-29/h1-2,4-7,16,29H,3,8-15H2 | StdInChIKey_Ref = {{stdinchicite|correct|chemspider}} | StdInChIKey = PLDUPXSUYLZYBN-UHFFFAOYSA-N }} <!-- Definition and medical uses --> '''Fluphenazine''', sold under the brand name '''Prolixin''' among others, is a high-potency typical antipsychotic medication of the phenothiazine class.<ref name=AHFS2015>{{cite web | title = fluphenazine decanoate | url = https://www.drugs.com/monograph/fluphenazine-decanoate.html | publisher = The American Society of Health-System Pharmacists | access-date = 1 December 2015 | url-status = live | archive-url = https://web.archive.org/web/20151208191534/http://www.drugs.com/monograph/fluphenazine-decanoate.html | archive-date = 8 December 2015 }}</ref> It is used in the treatment of chronic psychoses such as schizophrenia,<ref name="AHFS2015" /><ref name=TGA>{{cite web | title = Product Information: Modecate (Fluphenazine Decanoate Oily Injection ) | date = 1 November 2012 | work = TGA eBusiness Services | publisher = Bristol-Myers Squibb Australia Pty Ltd | access-date = 9 December 2013 | url = https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-02643-3 | format = PDF | url-status = live | archive-url = https://web.archive.org/web/20170802135209/https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-02643-3 | archive-date = 2 August 2017 }}</ref> and is about equal in effectiveness to low-potency antipsychotics like chlorpromazine.<ref>{{cite journal | vauthors = Tardy M, Huhn M, Engel RR, Leucht S | title = Fluphenazine versus low-potency first-generation antipsychotic drugs for schizophrenia | journal = The Cochrane Database of Systematic Reviews | volume = 2014 | issue = 8 | date = August 2014 | pmid = 25087165 | pmc = 10898219 | doi = 10.1002/14651858.CD009230.pub2 | article-number = CD009230 }}</ref> It is also used to treat depression in combination with nortriptyline.<ref name="DB00623" /><ref>{{Cite book |title=XPharm: The Comprehensive Pharmacology Reference |date=2007-01-01 |chapter=Fluphenazine |chapter-url=https://www.sciencedirect.com/science/chapter/referencework/abs/pii/B9780080552323617726 |language=en-US |pages=1–7 |doi=10.1016/B978-008055232-3.61772-6 |isbn=978-0-08-055232-3 | vauthors = Davis C }}</ref> In addition to the oral form, fluphenazine comes in decanoate and enanthate depot injection versions for increased adherence.<ref>{{cite journal | vauthors = Johnson DA | title = Historical perspective on antipsychotic long-acting injections | journal = The British Journal of Psychiatry. Supplement | volume = 52 | issue = S52 | pages = S7-12 | date = November 2009 | pmid = 19880921 | doi = 10.1192/bjp.195.52.s7 }}</ref> Fluphenazine is given by mouth, intramuscularly, or just under the skin.<ref name="AHFS2015" />

<!-- Side effects and mechanism --> Common side effects include movement problems, sleepiness, depression and increased weight.<ref name="AHFS2015" /> Serious side effects may include neuroleptic malignant syndrome, low white blood cell levels, and the potentially permanent movement disorder tardive dyskinesia.<ref name="AHFS2015" /> In older people with psychosis as a result of dementia it may increase the risk of dying.<ref name="AHFS2015" /> It may also increase prolactin levels which may result in milk production, enlarged breasts in males, impotence, and the absence of menstrual periods.<ref name="AHFS2015" /> It is unclear if it is safe for use in pregnancy.<ref name="AHFS2015" /> Fluphenazine decanoate should not be used by people with severe depression.<ref>{{Cite web |title=Modecate Injection 25mg/ml - Patient Information Leaflet (PIL) - (eMC) |url=http://www.medicines.org.uk/emc/medicine/15355/PIL/Modecate+Injection+25mg+ml |archive-url=https://web.archive.org/web/20171107012917/http://www.medicines.org.uk/emc/medicine/15355/PIL/Modecate+Injection+25mg+ml |archive-date=7 November 2017 |access-date=6 November 2017 |website=www.medicines.org.uk |language=en}}</ref><ref>{{Cite web |date=2013-03-28 |title=Depot Neuroleptika: Umrechnung der oralen Dosis in eine Depot-Dosis |url=https://psychiatrietogo.de/2013/03/28/depot-neuroleptika-umrechnung-der-oralen-dosis-in-eine-depot-dosis/ |access-date=2025-07-15 |website=Psychiatrie to go |language=de-DE |vauthors=Dreher J}}</ref> In up to 40% of those on long term phenothiazines, liver function tests become mildly abnormal.<ref>{{cite journal |date=2012 |title=Fluphenazine |url=https://livertox.nih.gov/Fluphenazine.htm |pmid=31643176 |archive-url=https://web.archive.org/web/20130217040716/http://www.livertox.nih.gov/Fluphenazine.htm |archive-date=17 February 2013 |access-date=6 November 2017 |website=livertox.nih.gov}}</ref>

Fluphenazine is a dopamine antagonist, blocking mesolimbic dopamine receptors.<ref name="AHFS2015" /><ref name="DB00623" /> Fluphenazine inhibits tubulin polymerization, a property shared with other phenothiazine derivatives including perphenazine, chlorpromazine, trifluoperazine, and triflupromazine.<ref>{{cite journal | vauthors = Baksheeva V, La Rocca R, Allegro D, Derviaux C, Pasquier E, Roche P, Morelli X, Devred F, Golovin AV, Tsvetkov PO | title = NanoDSF Screening for Anti-tubulin Agents Uncovers New Structure-Activity Insights | journal = Journal of Medicinal Chemistry | volume = 68 | issue = 16 | pages = 17485–17498 | date = August 2025 | pmid = 40815226 | doi = 10.1021/acs.jmedchem.5c01008 | pmc = 12406199 }}</ref>

<!-- History, society, and culture --> Fluphenazine was the third antipsychotic FDA approved in the United States in 1959, and 9 years later was the first FDA approved injectable antipsychotic.<ref>{{Cite web |title=fluphenazine (Permitil, Prolixin): Antipsychotic Side Effects & Dosage |url=https://www.medicinenet.com/fluphenazine-oral/article.htm |access-date=2025-11-17 |website=MedicineNet |language=en}}</ref><ref name="McPherson_2007">{{cite book | vauthors = McPherson EM | title = Pharmaceutical Manufacturing Encyclopedia. | location = Burlington | date = 2007 | publisher = Elsevier | isbn = 978-0-8155-1856-3 | page = 1680 | edition = 3rd | url = https://books.google.com/books?id=_J2ti4EkYpkC&pg=PA1680 }}</ref> The injectable form is on the World Health Organization's List of Essential Medicines.<ref name="World_Health_Organization_2019">{{cite book | vauthors = ((World Health Organization)) | title = World Health Organization model list of essential medicines: 21st list 2019 | location = Geneva | year = 2019 | hdl = 10665/325771 | author-link = World Health Organization | publisher = World Health Organization | id = WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO | hdl-access = free }}</ref> It is available as a generic medication.<ref name="AHFS2015" /> It was discontinued in Australia in 2017.<ref name=Au2017>{{cite web | veditors = Rossi S | title = Fluphenazine - Australian Medicines Handbook | date = July 2017 | work = Australian Medicines Handbook | place = Adelaide, Australia | publisher = Australian Medicines Handbook Pty Ltd | access-date = 8 August 2017 | url = https://amhonline.amh.net.au/chapters/chap-18/antipsychotics/fluphenazine }}</ref>

==Medical use== A 2018 Cochrane review found that fluphenazine was an imperfect treatment and other inexpensive drugs less associated with side effects may be an equally effective choice for people with schizophrenia.<ref>{{cite journal | vauthors = Matar HE, Almerie MQ, Sampson SJ | title = Fluphenazine (oral) versus placebo for schizophrenia | journal = The Cochrane Database of Systematic Reviews | volume = 6 | issue = 6 | date = June 2018 | pmid = 29893410 | pmc = 6513420 | doi = 10.1002/14651858.CD006352.pub3 | article-number = CD006352 }}</ref> Another 2018 Cochrane review found that there was limited evidence that newer atypical antipsychotics were more tolerable than fluphenazine.<ref name="Sampford_2016">{{cite journal | vauthors = Sampford JR, Sampson S, Li BG, Zhao S, Xia J, Furtado VA | title = Fluphenazine (oral) versus atypical antipsychotics for schizophrenia | journal = The Cochrane Database of Systematic Reviews | volume = 2016 | issue = 7 | date = July 2016 | pmid = 27370402 | pmc = 6474115 | doi = 10.1002/14651858.CD010832.pub2 | doi-access = free | article-number = CD010832 }}</ref> Intramuscular depot injection forms are available as both the decanoate and enanthate esters.<ref name="Maayan_2015">{{cite journal | vauthors = Maayan N, Quraishi SN, David A, Jayaswal A, Eisenbruch M, Rathbone J, Asher R, Adams CE | title = Fluphenazine decanoate (depot) and enanthate for schizophrenia | journal = The Cochrane Database of Systematic Reviews | volume = 2015 | issue = 2 | date = February 2015 | pmid = 25654768 | pmc = 10388394 | doi = 10.1002/14651858.CD000307.pub2 | doi-access = free | article-number = CD000307 }}</ref>

==Side effects==

===Discontinuation=== The British National Formulary recommends a gradual withdrawal when discontinuing antipsychotics to avoid acute withdrawal syndrome or rapid relapse.<ref name="Group 2009 192">{{cite book | chapter = 4.2.1 | title = British National Formulary | location = United Kingdom | date = March 2009 | editor1-first = BMJ | editor = Joint Formulary Committee | edition = 57 | publisher = Royal Pharmaceutical Society of Great Britain | isbn = 978-0-85369-845-6 | page = 192 | quote = Withdrawal of antipsychotic drugs after long-term therapy should always be gradual and closely monitored to avoid the risk of acute withdrawal syndromes or rapid relapse. }}</ref> Symptoms of withdrawal commonly include nausea, vomiting, and loss of appetite.<ref name="Haddad_2004">{{cite book | vauthors = Haddad P, Haddad PM, Dursun S, Deakin B | title = Adverse Syndromes and Psychiatric Drugs: A Clinical Guide | pages = 207–216 | date = 2004 | publisher = OUP Oxford | isbn = 978-0-19-852748-0 | url = https://books.google.com/books?id=CWR7DwAAQBAJ&pg=PA207 | language = en }}</ref> Other symptoms may include restlessness, increased sweating, and trouble sleeping.<ref name="Haddad_2004" /> Less commonly there may be a feeling of the world spinning, numbness, or muscle pains.<ref name="Haddad_2004" /> Symptoms generally resolve after a short period of time.<ref name="Haddad_2004" />

There is tentative evidence that discontinuation of antipsychotics can result in psychosis.<ref>{{cite journal | vauthors = Moncrieff J | title = Does antipsychotic withdrawal provoke psychosis? Review of the literature on rapid onset psychosis (supersensitivity psychosis) and withdrawal-related relapse | journal = Acta Psychiatrica Scandinavica | volume = 114 | issue = 1 | pages = 3–13 | date = July 2006 | pmid = 16774655 | doi = 10.1111/j.1600-0447.2006.00787.x | s2cid = 6267180 }}</ref> It may also result in reoccurrence of the condition that is being treated.<ref>{{cite book | vauthors = Sacchetti E, Vita A, Siracusano A, Fleischhacker W | title = Adherence to Antipsychotics in Schizophrenia | date = 2013 | publisher = Springer Science & Business Media | isbn = 978-88-470-2679-7 | page = 85 | url = https://books.google.com/books?id=odE-AgAAQBAJ&pg=PA85 | language = en }}</ref> Rarely tardive dyskinesia can occur when the medication is stopped.<ref name="Haddad_2004" />

==Pharmacology==

===Pharmacodynamics=== {{See also|Antipsychotic#Pharmacodynamics|Antipsychotic#Comparison of medications}}

Fluphenazine acts primarily by blocking post-synaptic dopaminergic D<sub>2</sub> and D<sub>1</sub> receptors in the basal ganglia, cortical and limbic system.<ref name="DB00623" /> It also blocks α<sub>1</sub> adrenergic receptors, muscarinic M<sub>1</sub> receptors, and histaminergic H<sub>1</sub> receptors, and like other phenothiazines, it competitively inhibits calmodulin.<ref>{{cite journal |vauthors=Siragusa S, Bistas KG, Saadabadi A |year=2020 |title=Fluphenazine |url=https://www.ncbi.nlm.nih.gov/books/NBK459194/ |journal=StatPearls |pmid=29083807}}</ref><ref>{{Cite web |title=Fluphenazine |url=https://pubchem.ncbi.nlm.nih.gov/compound/3372 |access-date=30 September 2019 |work=PubChem |publisher=U.S. National Library of Medicine |language=en}}</ref><ref name="Wrenn_1981">{{cite journal | vauthors = Wrenn RW, Katoh N, Schatzman RC, Kuo JF | title = Inhibition by phenothiazine antipsychotic drugs of calcium-dependent phosphorylation of cerebral cortex proteins regulated by phospholipid or calmodulin | journal = Life Sciences | volume = 29 | issue = 7 | pages = 725–733 | date = August 1981 | pmid = 7278508 | doi = 10.1016/0024-3205(81)90026-6 }}</ref> Fluphenazine depresses both the release of hypothalamic and hypophyseal hormones and the reticular activating system.<ref name="DB00623" />

{| class="wikitable floatright" style="font-size:small;" |+ Binding Affinities of Fluphenazine<ref name="Wrenn_1981" /><ref name="PDSP">{{cite web | vauthors = Roth BL, Driscol J | title = PDSP K<sub>i</sub> Database | author1-link = Bryan Roth | website = Psychoactive Drug Screening Program (PDSP) | publisher = University of North Carolina at Chapel Hill and the United States National Institute of Mental Health | access-date = 14 August 2017 | url = https://pdsp.unc.edu/databases/pdsp.php?knowID=0&kiKey=&receptorDD=&receptor=&speciesDD=&species=&sourcesDD=&source=&hotLigandDD=&hotLigand=&testLigandDD=&testFreeRadio=testFreeRadio&testLigand=fluphenazine&referenceDD=&reference=&KiGreater=&KiLess=&kiAllRadio=all&doQuery=Submit+Query }}</ref><ref name="DB00623">{{Cite web | title = Fluphenazine | url = https://go.drugbank.com/drugs/DB00623 | access-date = 2025-10-18 | website = go.drugbank.com | language = en }}</ref><ref>{{cite book | vauthors = Siragusa S, Bistas KG, Saadabadi A | chapter = Fluphenazine | title = StatPearls | date = 2025 | pmid = 29083807 | chapter-url = http://www.ncbi.nlm.nih.gov/books/NBK459194/ | access-date = 2025-10-18 | place = Treasure Island (FL) | publisher = StatPearls Publishing }}</ref> |- ! Target !! K<sub>i</sub> (nM) !! Action |- | D<sub>2</sub>|| 0.89 || Antagonist |- | D<sub>1</sub>|| 14.45 || Antagonist |- | 5-HT<sub>2A</sub>|| 3.8–98 || Antagonist |- | 5-HT<sub>1B</sub>|| 334|| Modulator |- | 5-HT<sub>2C</sub>|| 174–2,570 || Antagonist |- |AR |ND |Antagonist |- | α<sub>1A</sub>|| 6.4–9 || Antagonist |- | H<sub>1</sub>|| 7.3–70 || Antagonist |- | M<sub>1</sub>|| 1,095-3,235.93 || Antagonist |- |Calmodulin |ND |Inhibitor |- class="sortbottom" | colspan="3" style="width: 1px;" | The smaller the Ki, the more strongly the drug binds to the site. All data are for human cloned proteins, except 5-HT<sub>3</sub> (rat).<ref name="PDSP" /> |}

=== Pharmacokinetics === {{See also|Antipsychotic#Pharmacokinetics|Antipsychotic#Pharmacokinetics of long-lasting injectable antipsychotics}}

Oral fluphenazine rapidly absorbs and plasma levels peak at about 1.0-2.5&nbsp;ng/mL 2 hours post-ingestion.<ref name="Dysken_1981">{{cite journal | vauthors = Dysken MW, Javaid JI, Chang SS, Schaffer C, Shahid A, Davis JM | title = Fluphenazine pharmacokinetics and therapeutic response | journal = Psychopharmacology | volume = 73 | issue = 3 | pages = 205–210 | date = 1981-05-01 | pmid = 6787637 | doi = 10.1007/BF00422403 }}</ref><ref name="PubChem_2025">{{Cite web |work = PubChem |title=Hazardous Substances Data Bank (HSDB) : 3334 |url=https://pubchem.ncbi.nlm.nih.gov/source/hsdb/3334#section=Absorption-Distribution-and-Excretion-(Complete) |access-date=2025-12-12 | publisher = U.S. National Library of Medicine |language=en}}</ref> The volume of distribution is about 298 L due to extensive tissue uptake, and it crosses the blood brain barrier.<ref name="PubChem_2025" /> Bioavailability is low at 2.7% due to first pass metabolism,<ref>{{cite journal | vauthors = Koytchev R, Alken RG, McKay G, Katzarov T | title = Absolute bioavailability of oral immediate and slow release fluphenazine in healthy volunteers | journal = European Journal of Clinical Pharmacology | volume = 51 | issue = 2 | pages = 183–187 | date = 1996-10-01 | pmid = 8911886 | doi = 10.1007/s002280050182 }}</ref> and the half-life is about 14–16 hours.<ref name="Dysken_1981" /><ref name="Curry_1979"/> Steady state concentrations vary considerably across individuals, which indicates variability in absorption, metabolism, or excretion.<ref name="Dysken_1981" /> Additionally, the dose-level relationship is curvilinear with plasma levels of 0.2 - 2.8&nbsp;ng/mL being optimal for clinical improvement.<ref name="Dysken_1981" /> Fluphenazine is primarily metabolized to fluphenazine sulfoxide by the cytochrome P450 2D6.<ref name="DB00623" /> Benztropine mesylate did not indicate any major drug-drug interactions.<ref name="Dysken_1981" /> Fluphenazine is exreted primarily through urine and feces.

Injectable fluphenazine is dissolved in sesame oil which forms a localized oil depot in the muscle.<ref name="Luo_1997">{{cite journal | vauthors = Luo JP, Hubbard JW, Midha KK | title = Studies on the mechanism of absorption of depot neuroleptics: fluphenazine decanoate in sesame oil | journal = Pharmaceutical Research | volume = 14 | issue = 8 | pages = 1079–1084 | date = August 1997 | pmid = 9279892 | doi = 10.1023/a:1012165731390 }}</ref> Due to the lipophilicity of the added decanoate or enanthate group, the drug remains in the oil causing the rate-limiting step for drug being diffusion out, resulting in flip-flop kinetics.<ref name="Luo_1997" /> Fluphenazine decanoate and enanthate are prodrugs which are hydrolyzed by esterases to fluphenazine.<ref name="Luo_1999">{{Cite thesis | vauthors = Luo JP | degree = Ph.D. |date= March 1999 |title=Pharmacokinetic studies of fluphenazine and four ester prodrugs | publisher = University of Saskatchewan |url=http://hdl.handle.net/10388/etd-10212004-002057 |language=en-US}}</ref> The fluphenazine decanoate acts within 1–3 days, and its effect lasts an average of 2 weeks.<ref name="PubChem_2025" /> The half-life of fluphenazine decanoate is about 6.8-9.6 days,<ref name="PubChem_2025" /><ref name="Curry_1979">{{cite journal | vauthors = Curry SH, Whelpton R, de Schepper PJ, Vranckx S, Schiff AA | title = Kinetics of fluphenazine after fluphenazine dihydrochloride, enanthate and decanoate administration to man | journal = British Journal of Clinical Pharmacology | volume = 7 | issue = 4 | pages = 325–331 | date = April 1979 | pmid = 444352 | pmc = 1429660 | doi = 10.1111/j.1365-2125.1979.tb00941.x }}</ref> and plasma levels peak at about 2.18&nbsp;ng/mL about 4–6 hours post injection.<ref name="Luo_1999" /> Fluphenazine enanthate has a lower half life of about 3.6-3.7 days, reflecting its decreased lipophilicity.<ref name="PubChem_2025" /><ref name="Curry_1979" /> {{Pharmacokinetics of long-acting injectable antipsychotics}}

==Availability== The injectable form is on the World Health Organization's List of Essential Medicines.<ref name="World_Health_Organization_2019" /> It is available as a generic medication.<ref name="AHFS2015" /> It was discontinued in Australia in 2017.<ref name="Au2017" />

== Veterinary == In horses, it is sometimes given by injection as an anxiety-relieving medication, though there are many negative common side effects and it is forbidden by many equestrian competition organizations.<ref>{{cite web | vauthors = Loving NS | title = Effects of Behavior-Modifying Drug Investigated (AAEP 2011) | date = 31 March 2012 | url = http://www.thehorse.com/articles/28907/effects-of-behavior-modifying-drug-investigated-aaep-2011 | publisher = The Horse Media Group | access-date = 13 December 2016 | url-status = live | archive-url = https://web.archive.org/web/20170106203758/http://www.thehorse.com/articles/28907/effects-of-behavior-modifying-drug-investigated-aaep-2011 | archive-date = 6 January 2017 }}</ref>

== References == {{Reflist}}

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