Antipsychotics trifluoperazine

Of the antipsychotic drugs prescribed, 72% were typical antipsychotics, which included haloperidol, chlorpromazine, levomepromazine, sulpiride, trifluoperazine, fluphenazine, flupentixol, and bromperidol. Use of typical drugs was associated with longer hospitalization, male gender, and clinical reports of violence or aggression. Atypical drugs only accounted for 28% of antipsychotic drugs... 

If a change in antipsychotic therapy is required, risperidone, molindone, thioridazine, haloperidol, pimozide, trifluoperazine, and fluphenazine may be considered. 

Whatever the underlying causes may be, neuroleptic medications are the most effective treatment for schizophrenia. All antipsychotic medications have some form of dopamine receptor antagonism and they are distinguished by their chemical class. The phenothiazines include chlorpromazine (Thorazine), thioridazine (Mellaril), mesoridazine (Serentil), trifluoperazine (Stelazine), fluphenazine (Prolixin), and prochlorperazine (Compazine). The thioxanthenes include chlorprohixine (Taractan) and thiothixene (Navane). Butyrophenones are represented by haloperidol (Haldol). Loxapine (Loxitane) is a dibenzoxapine, and molindone (Moban) is a dihydroindolone. 

Co-careldopa is a combination of levodopa and the peripheral dopadecar-boxylase inhibitor. Co-careldopa is indicated in Parkinson s disease to improve bradykinesia and rigidity rather than tremor. Orphenadrine is an antimuscarinic agent indicated in patients with Parkinson s disease where tremor predominates. Trifluoperazine is a piperazine antipsychotic that should be used with caution in patients with Parkinson s disease as its use may exacerbate the condition. 

Tardive dyskinesia is a chronic movement disorder characterised by uncontrolled facial movement disorders. Tardive dyskinesia is associated with the use of antipsychotics such as trifluoperazine. 

From the chemical point of view antipsychotic drugs are subdivided into six chemical groups, as well as to the group of non-classifiable drugs. They are phenothiazines (chlorpromazine, promazine, triflupromazine, acetophenazine, fluphenazine, perphenazine, prochlorpherazine, trifluoperazine, mesoridazine, and thioridazine), thioxanthenes... 

Trifluoperazine is one of the most active antipsychotic drugs. A moderate stimulatory effect accompanies the neuroleptic effect. Trifluoperazine is unique in that, patients instead of the usual stiffness and weakness characteristic of phenothazine derivatives, become more lively. This drug has a strong anticonvulsant activity. It is widely used in psychiatry for treating schizophrenia and other mental illnesses. The most common synonyms are mobadid, triftazin, stelazine, cahnazin, and others. 

The piperazines include fluphenazine, trifluoperazine, prochlorperazine, perazine and perphenazine. They are agents with a high antipsychotic potency with less pronounced anticholinergic effects. However their potential to produce extrapyramidal effects is more pronounced. 

Trifluoperazine is also a more potent antipsychotic than chlorpromazine with only minor sedative, anticholinergic and cardiovascular activity. 

A variety of relatively uncommon dermatological side effects have been noted to be associated with antipsychotic agents. These include maculopapular rashes, urticaria, and erythema multiforme (Arana, 2000). Photosensitivity and skin pigmentation can also occur during treatment with these drugs. Although skin pigmentation has been most frequently reported with chlorpromazine, this can occur with thioridazine and trifluoperazine (Harth and Rapoport, 1996). In addition, treatment-induced alopecia has been reported for haloperidol, olanzapine, and risperidone (Mercke et ah, 2000). 

Fish, B., Campbell, M., Shapiro, T, and Floyd, A. (1969) Comparison of trifluperidol, trifluoperazine and chlorpromazine in preschool schizophrenic children the value of less sedative antipsychotic agents. Curr Ther Res 11 589-595. 

Further, it is best to start with a very low dose and titrate up slowly in a hospital setting to carefully monitor clinical response, temperature, and neurological and mental status. Using low doses will not necessarily jeopardize chances for an adequate clinical response. We found, for example, evidence for a therapeutic effect with low-dose trifluoperazine (285). This finding is consistent with the growing recognition that less may indeed be more when it comes to the dose of an antipsychotic. 

We also have used 19F NMR and ICD spectra to study interactions of trifluoperazine with calmodulin under various conditions where no aggregation of trifluoperazine occurs. Antipsychotic drugs such as trifluoperazine (TFP) are strongly bound to calmodulin (CaM) in the presence of Ca2+ and behave as potent CaM antagonists I60161>. 

Trifluoperazine (TFP) is an antipsychotic phenothiazine drug which is bound strongly to brain calmodulin and is a potent calmodulin antagonist. TFP is believed to be bound to... 

First-generation (typical) antipsychotics include amisulpride, chlorpromazine, fluphenazine, haloperidol, promethazine, promazine, trifluoperazine... 

A 44-year-old man with major depression had been taking the antipsychotic drug trifluoperazine (3 mg/ day) for anxiety for several years (51). He was given venlafaxine 75 mg/day, and 12 hours after the first dose developed anxiety and malaise. He was sweating and had tremor and rigidity. His blood pressure fluctuated... 

INDIRECT ANTIPSYCHOTICS 1. Case reports of paralytic ileus with trifluoperazine and methylphenidate 2. Case report of acute dystonias with haloperidol and dexamfetamine 3.1 efficacy of chlorpromazine when dexamfetamine was added 1. Additive anticholinergic effect 2. Uncertain possibly due to t dopamine release 3. Uncertain 1. Watch for signs of altered bowel habit 2. Warn patients of this rare interaction 3. Avoid co-administration... 

PHENOTHIAZINES - CHLORPROMAZINE, PERPHENAZINE, PROCHLORPERAZINE, TRIFLUOPERAZINE Antipsychotics, below ... 

Patients with inadequate responses to atypical antipsychotics may benefit from a trial of augmentation with a conventional antipsychotic such as trifluoperazine or from switching to a conventional antipsychotic such as trifluoperazine... 

However, long-term polypharmacy with a combination of a conventional antipsychotic such as trifluoperazine with an atypical antipsychotic may combine their side effects without clearly augmenting the efficacy of either... 

The classical antipsychotic (see p. 380) drugs block dopamine receptors and their antipsychotic activity relates closely to this action, which notably involves the Dj-receptor, the principal target in Parkinson s disease. It comes as no surprise, therefore, that these drugs can induce a state whose clinical features are very similar to those of idiopathic Parkinson s disease. The piperazine phenothiazines, e.g. trifluoperazine, and the butyrophenones, e.g. haloperidol, are most commonly involved. In one series of 95 new cases of parkinsonism referred to a department of geriatric medicine, 51% were associated with prescribed drugs and half of these required hospital admission. After withdrawal of the offending drug most cases resolved completely in 7 weeks. But... 

Molindone Hydrochloriele. Molindone hydrochloride. 3-ethyl-6.7-dihydro-2-mcthyl-5-morpholinomcthyl)indole-4(S//)-one monohydrochloride (Mohan), is about as potent an antipsychotic as trifluoperazine. Overall, side effects resemble those of (he phenothiazines. 

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