Chlorpromazine

What is chlorpromazine?

First generation ‘typical’ antipsychotics such as chlorpromazine are an older class of antipsychotic than second generation ‘atypical’ antipsychotics. They are used primarily to treat positive symptoms including the experiences of perceptual abnormalities (hallucinations) and fixed, false, irrational beliefs (delusions). First generation antipsychotics may cause side effects which can differ depending on which antipsychotic is being administered and on individual differences in reaction to the drug. Reactions may include dyskinesias such as repetitive, involuntary, and purposeless body or facial movements, Parkinsonism (cogwheel muscle rigidity, pill-rolling tremor and reduced or slowed movements), akathisia (motor restlessness, especially in the legs, and resembling agitation) and dystonias such as muscle contractions causing unusual twisting of parts of the body, most often in the neck. These effects are caused by the dopamine receptor antagonist action of these drugs.

What is the evidence for chlorpromazine?

Moderate quality evidence suggests chlorpromazine reduces relapse and improves symptoms and functioning when compared to placebo, however chlorpromazine is sedating, causes a lowering of blood pressure and more weight gain. When compared to haloperidol, there is less risk of movement disorders, but more risk of hypotension. There is greater improvement in global state with high-dose (2gms/day) than low-dose (≤400mg/day) chlorpromazine, but less dystonia and extrapyramidal effects with low-dose chlorpromazine.

October 2019

Last updated at: 3:08 am, 8th October 2019
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Title Colour Legend:
Green - Topic summary is available.
Orange - Topic summary is being compiled.
Red - Topic summary has no current systematic review available.