Extrapyramidal reactions may occur, especially during the first few days after injection and in the early phase of treatment. In most cases these side effects can be satisfactorily controlled by reduction of dosage and/or use of antiparkinsonian drugs. The routine prophylactic use of antiparkinsonian drugs is not recommended. Antiparkinsonian drugs do not alleviate tardive dyskinesia and may aggravate them. Reduction in dosage or, if possible, discontinuation of flupentixol decanoate therapy is recommended. In persistent akathisia, a benzodiazepine or propranolol may be useful.