Chlorpromazine (CPZ) : Therapeutic uses, Dosage & Side Effects

Chlorpromazine (CPZ) : Therapeutic uses, Dosage & Side Effects

Chlorpromazine (CPZ) is a first-generation typical antipsychotic drug, indicated for treating the psychotic disorders like schizophrenia,  intractable hiccups, bipolar disorders, attention deficit hyperactivity disorder ADHD, nausea etc.
Dose : 100-800 mg (Oral)
Route : Oral, Intramuscular, Intravenous
Plasma Half-life : 30 hours
Duration of action : N/A
Bioavailability : 10-80% (Oral)
Chemical formula : C17H19ClN2S
IUPAC name : 3-(2-chloro-10H-phenothiazin-10-yl)-N,N-dimethyl-propan-1-amine
Trade name : Thorazine, Largactil, Hibernal, Megaphen
Therapeutic uses :
Chlorpromazine has following usage :

  • Primarily indicated as anti-psychotic drug for treating psychoses particularly Schizophrenia. It is most effective in treating positive symptoms of schizophrenia.
  • CPZ is best preferred when schizophrenic patient is Agitated, combative and violent.
  • Can be for the management of the manic and mixed symptoms associated with bipolar disorder.
  • Used to treat intractable hiccups.
  • Can be used as anti-emetic agent thus, useful in the prevention of nausea and vomiting, particularly treatment of drug-induced nausea. It is effective in morning sickness but not in motion sickness.
  • Can be used as tranquilizers to manage agitated and disruptive behavior secondary to other disorders.
  • May relieve anxiety but should not be used for simple anxiety because of autonomic and extrapyramidal side effects.
  • May be used for Organic brain syndromes on a short-term basis.
  • May be used a secondary drug to achieve skeletal muscle relaxation in tetanus.
  • Rare indications includes Alcoholic hallucinosis, Huntington’s disease and Gilles de Ia Tourette’s syndrome.

Warnings : 

  • Increased Mortality in Elderly Patients with Dementia-Related behavioral disturbances and psychosis

Side effects : Adverse effects of the CPZ can occur in practically all patients and are significant in about 80% ; CPZ may produce following side effects:

  • CNS ailments like Sedation, drowsiness, lethargy, mental confusion, increased appetite, weight gain, aggravation of seizures
  • CVS effects including Postural (orthostatic)hypotension, palpitation, inhibition of ejaculation
  • Anticholinergic effects such as Dry mouth, blurring of vision, constipation, urinary hesitancy in elderly males
  • Extrapyramidal disturbances (extrapyramidal symptoms EPS) such as Parkinsonism, Acute muscular dystonias, Akathisia, Malignant neuroleptic syndrome, Tardive dyskinesia
  • Blue pigmentation of exposed skin,
  • Corneal and lenticular opacities, retinal degeneration,
  • Cholestatic jaundice,
  • Skin rashes, urticaria, contact dermatitis, photosensitivity

Contraindications :

  • It should be used cautiously in patients with seizure disorders (since it may lower the seizure threshold)or those with an increased risk for seizures, such as withdrawal from alcohol.
  • Do not use in patients with known hypersensitivity to phenothiazines.
  • Do not use in comatose states or in the presence of large amounts of central nervous system depressants (alcohol, barbiturates, narcotics, etc.).

For detailed query or in case of uncertainty, Always consult your doctor or pharmacist.

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