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Chlorpromazine (Thorazine) is a first-generation antipsychotic used to treat schizophrenia, bipolar mania, severe behavioral problems, and intractable hiccups.
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Dr. Steven Blikstein, PharmD
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Chlorpromazine is a first-generation (typical) antipsychotic in the phenothiazine class that works primarily by blocking dopamine D2 receptors in the brain, with additional anticholinergic, antihistaminic, and alpha-adrenergic blocking effects. It is used to treat schizophrenia, the manic phase of bipolar disorder, severe behavioral problems in children, intractable hiccups, and as an adjunct for nausea, vomiting, and preoperative sedation. Dosing varies widely by indication and is individualized, starting low and titrated based on response and tolerability. Common side effects include sedation, orthostatic hypotension, dry mouth, constipation, blurred vision, weight gain, and photosensitivity. Extrapyramidal symptoms (tremor, rigidity, akathisia) and, with long-term use, tardive dyskinesia can occur. Chlorpromazine carries a boxed warning for increased risk of death in elderly patients with dementia-related psychosis and is not approved for this use.
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Chlorpromazine (Thorazine) is a first-generation antipsychotic used for schizophrenia, bipolar mania, severe behavioral problems, and intractable hiccups. It blocks dopamine D2 receptors along with anticholinergic, antihistaminic, and alpha-adrenergic effects.
Boxed Warning: Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at increased risk of death. Chlorpromazine is not approved for the treatment of dementia-related psychosis.
Common side effects include sedation, orthostatic hypotension, dry mouth, constipation, blurred vision, weight gain, and photosensitivity. Extrapyramidal symptoms (tremor, rigidity, akathisia) can occur, and long-term use carries a risk of tardive dyskinesia.