Trifluoperazine schizophrenia

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. 

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. 

Hedberg DL, Houck JH, Glueck BC Jr. Tranylcypromine-trifluoperazine combination in the treatment of schizophrenia. Am J Psychiatry 1971 127 1141-1146. 

A 50-year-old woman with schizophrenia had a 1-year history of gradual deterioration of vision in both eyes. For several years she had been taking chlorpromazine 300 mg/day, trifluoperazine 10 mg/day, and trihexyphenidyl 4 mg/day. Slit lamp examination showed fine, discrete, brown refractile deposits on the corneal endothelium in both eyes, and characteristic bilateral stellate cataracts with dense, dust-like brown-yellow granular deposits were noted along the suture lines in the anterior pole of the lens and obscured the visual axis. 

A 38-year-old woman was admitted to hospital in the third week after conception and acute schizophrenia was diagnosed. She was given oral haloperidol 1.5 mg at 12-hourly intervals. In the fourth week after conception, intramuscular depot fluphenazine 12.5 was added every 15 days. At 8 weeks of gestation, after the pregnancy had been diagnosed, haloperidol and fluphenazine were withdrawn and trifluoperazine 5 mg was started and continued until 8 weeks before the baby was bom. The child was bom with phocomelia of the left arm, with an extremely short humerus and an absent forearm. 

Doongaji DR, Satoskar RS, Sheth AS, Apte JS, Desai AB, Shah BR. Centbutindole vs trifluoperazine a double-blind controlled clinical study in acute schizophrenia. J Postgrad Med 1989 35 3-8. 

Trifluoperazine (Stelazine) U u Schizophrenia, acute psychoses, schizoaffective disorder, paranoid syndrome, nausea and vomiting Less sedative effects and orthostatic hypotension, but more extrapyramidal effects than chlorpromazine... 

In one study, 8 normotensive patients given methyldopa 500 mg to 1 g daily with chlorpromazine 200 to 400 mg daily for schizophrenia experienced orthostatie dizziness and had reductions in their standing systolic blood pressure. In eontrast, an isolated report describes a paradoxical rise in blood pressure in a patient with systemic lupus erythematosus and renal failure when methyldopa and trifluoperazine were given. When the trifluoperazine was stopped, the blood pressure fell. ... 

Observational studies In a retrospective comparison of risperidone with haloperidol or trifluoperazine in an Asian population with first-episode schizophrenia-spectrum disorders ( = 261), some 90% discontinued treatment before 18 months however, the median time to discontinuation of risperidone was 69 days compared with 27 days for the first-generation antipsychotic drugs [123 ]. Risperidone had a longer time to discontinuation owing to intolerable adverse reactions than haloperidol and trifluoperazine. Nevertheless, lack of comparability precluded firm conclusions. 

Additional studies on oxypertine (XIX) indicate that the major advantage of this compound is its mood elevating and stimulant properties in schizophrenics where apathy is a major problem.In a double blind study with chlorpromazine oxypertine was judged to be of value in the treatment of chronic schizophrenia, In two clinical studies, molindone (XX) was shown to be equal to trifluoperazine as an antipsychotic but antidepressant properties were not noted at the dosage used. "... 

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