Perphenazine

What is perphenazine?

First generation ‘typical’ antipsychotics such as perphenazine 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 perphenazine?

High quality evidence suggests no differences in effectiveness between oral perphenazine and other antipsychotics. Moderate quality evidence suggests severe toxicity is less frequent with perphenazine than with low-potency chlorpromazine, but akathisia is more frequent with perphenazine than with low-potency chlorpromazine or thioridazine. Moderate to low quality evidence suggests perphenazine enanthate is associated with more use of anticholinergic drugs than clopenthizol decanoate, with no differences in global improvement or relapse rates.

March 2019

Last updated at: 4:42 am, 22nd March 2019
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Fact Sheet Technical Commentary

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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.