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Perphenazine

Perphenazine

Definition

Perphenazine is a phenothiazine antipsychotic used to treat serious mental disorders. It has also been used to treat severe nausea and vomiting. It is sold in the United States under the brand name Trilafon and is also available under its generic name.

Purpose

Perphenazine is used to treat psychotic disorders and severe nausea and vomiting.

Description

Perphenazine is one of many drugs in the class called phenothiazine derivatives. Phenothiazines work by inhibiting the actions of the brain chemicals, dopamine and norepinephrine, which are overproduced in individuals with psychosis .

Recommended dosage

For the treatment of psychosis, adults usually receive a total of 4 mg to 16 mg taken as tablets in three or four doses daily, up to a maximum of 64 mg each day. Injections of perphenazine are also available and are typically given in 5 mg doses every six hours, up to 15 mg per day. Hospitalized patients can receive up to 30 mg per day in the injectable form of perphenazine.

Adult patients with serious nausea and vomiting receive 8 mg to 16 mg per day as tablets in divided into several doses up to a maximum of 24 mg per day. Injections are typically given in 5 mg to 10 mg doses every six hours, up to 15 mg per day in patients who are not confined to bed. Hospitalized patients can receive up to a maximum of 30 mg per day. Intravenous perphenazine can be given to nausea and vomiting patients up to 1 mg every one to two minutes to a maximum of 5 mg.

The correct dosage of perphenazine must be carefully determined for each patient. Physicians try to find a dose that controls symptoms of the disease without causing intolerable side effects. Dosage guidelines for the treatment of psychosis have not been established for children under the age of 12 years. In children over age 12, the lowest adult dosage is generally used to treat psychosis. Children with severe nausea and vomiting are usually given 5 mg injections every six hours.

Precautions

Persons who take perphenazine should not stop taking the drug abruptly. Instead, the dose should be decreased gradually, then stopped. People who take perphenazine often have develop sunburn more easily than Sunscreen should be used by people, especially fair-skinned individuals, taking perphenazine.

People who are known to have severe central nervous system depression should not take perphenazine or any other drug in its class. In addition, those with a prior history of brain damage, coma, or bone marrow depression should not receive perphenazine without a thorough evaluation by a doctor.

Children under the age of 12 years, the elderly (over age 65), those with a history of epilepsy, glaucoma, prostate problems, severe asthma, and other severe breathing problems should receive perphenazine only with great caution and under close supervision of a physician. In addition, persons with a history of heart or blood vessel disease and those with a history of liver or kidney disease should take perphenazine only after a thorough evaluation. Perphenazine should also be used cautiously when taken over a long period. Rarely should perphenazine be taken by pregnant or nursing women.

Side effects

Serious or life-threatening side effects due to perphenazine are rare. However, if any of these occur, patients should contact their doctors or get immediate medical attention: seizures , irregular heartbeat, significant changes in blood pressure, muscle stiffness, weakness, pale skin color, and increased sweating. The treating doctor should be contacted immediately if any of these common side effects develop: rapid movements of the tongue, uncontrolled chewing movement, unusual amounts of lip smacking, and frequent movement of the arms or legs. The treating doctor should be contacted relatively soon if any of the following common side effects develop: reduced balance control, muscle spasms, restlessness, trembling, weakness in the limbs, blurred vision, and decreased night vision.

Less common side effects that need to be reported to the doctor include severe sunburn, skin rashes, and urination problems. Rare side effects that should be reported to the doctor include abdominal pain, muscle aches, joint aches, fever, chills, muscle weakness, and vomiting. Common and not serious side effects include constipation, drowsiness, decreased sweating, mouth dryness, and nasal congestion. Uncommon and not typically serious side effects include decreased sexual desire, increased susceptibility to sunburn, menstrual cycle changes, swelling or pain in the breasts, and weight gain.

Interactions

Combining perphenazine with drugs such as the anti-mallarials amodiaquine, chloroquine, and sulfadoxine-pyrimethamine (Fansidar) can increase the concentrations within the body of these three latter drugs.

Perphenazine combined with barbiturates tends to lower the concentrations of perphenazine in the body. Combining perphenazine with clonidine (Catapres), guanadrel (Hylorel), and guanethidine (Ismelin) can produce dangerously low blood pressure.

Perphenazine should not be combined with alcohol, because alcohol increases the drug's depressive effect on the central nervous system. Perphenazine inhibits the effects of levodopa in Parkinson patients when the two are combined. Lithium combined with perphenazine lowers the levels of both drugs.

Perphenazine should not be combined with analgesics (pain killers) containing narcotics because of the combination increases depressive effects on the central nervous system. Orphenadrine (Norflex) combined with perphenazine can reduce the beneficial effects of perphenazine.

Resources

BOOKS

Consumer Reports Staff, eds. Consumer Reports Complete Drug Reference. 2002 ed. Denver: Micromedex Thomson Healthcare, 2001.

Ellsworth, Allan J. and others. Mosby's Medical Drug Reference. 2001-2002. St. Louis: Mosby, 2001.

Hardman, Joel G., Lee E. Limbird, eds. Goodman & Gilman's The Pharmacological Basis of Therapeutics. 10th ed. New York: McGraw-Hill, 2001.

Mosby's GenRx Staff. Mosby's GenRx. 9th ed. St. Louis: Mosby, 1999.

Venes, Donald, and others, eds. Taber's Cyclopedic Medical Dictionary. 19th ed. Philadelphia: F. A. Davis, 2001.

Mark Mitchell, M.D.

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perphenazine

perphenazine (per-fen-ă-zeen) n. a phenothiazine antipsychotic drug administered by mouth to treat schizophrenia, mania, anxiety, and severe agitation and to prevent and treat severe nausea and vomiting. Trade name: Fentazin.

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Perphenazine

Perphenazine

Definition

Purpose

Description

Recommended dosage

Precautions

Side effects

Interactions

Resources

Definition

Perphenazine is a phenothiazine antipsychotic used to treat serious mental disorders. It has also been used to treat severe nausea and vomiting. It is sold in the United States under the brand name Trilafon and is also available under its generic name.

Purpose

Perphenazine is used to treat psychotic disorders and severe nausea and vomiting.

Description

Perphenazine is one of many drugs in the class called phenothiazine derivatives. Phenothiazines work by inhibiting the actions of the brain chemicals, dopamine and norepinephrine, which are overproduced in individuals with psychosis . It is a member of the group of “first-generation” antipsychotics, which had fallen out of favor with the advent of the “second-generation” drugs, thought to be more effective and confer fewer side effects. However, a recent study found that perphenazine is as effective as some of the newer drugs and is more cost effective.

Recommended dosage

For the treatment of psychosis, adults usually receive a total of 4 mg to 16 mg taken as tablets in three or four doses daily, up to a maximum of 64 mg each day. There is also a liquid form available to be taken orally. Injections of perphenazine are also available and are typically given in 5 mg doses every 6 hours, up to 15 mg per day. Hospitalized patients can receive up to 30 mg per day in the injectable form of perphenazine.

Adult patients with serious nausea and vomiting receive 8 mg to 16 mg per day as tablets, divided into several doses, up to a maximum of 24 mg per day. Injections are typically given in 5 mg to 10 mg doses every 6 hours, up to 15 mg per day in patients who are not confined to bed. Hospitalized patients can receive up to a maximum of 30 mg per day. Intravenous perphenazine can be given to nausea and vomiting patients up to 1 mg every 1 to 2 minutes to a maximum of 5 mg.

The correct dosage of perphenazine must be carefully determined for each patient. Physicians try to find a dose that controls symptoms of the disease without causing intolerable side effects. Dosage guidelines for the treatment of psychosis have not been established for children under the age of 12 years. In children over age 12, the lowest adult dosage is generally used to treat psychosis. Children with severe nausea and vomiting are usually given 5 mg injections every six hours.

Precautions

Persons who take perphenazine should not stop taking the drug abruptly. Instead, the dose should be decreased gradually, then stopped. People who take perphenazine often develop sunburn easily; sunscreen should be used by persons, especially fair-skinned individuals, taking perphenazine.

Persons who are known to have severe central nervous system depression should not take perphena-zine or any other drug in its class. In addition, those with a prior history of brain damage, coma, or bone marrow depression should not receive perphenazine without a thorough evaluation by a doctor.

Children under the age of 12 years, the elderly (over age 65), those with a history of epilepsy, glaucoma, prostate problems, severe asthma, and other severe breathing problems should receive perphenazine only with great caution and under close supervision of a physician. In addition, persons with a history of heart or blood vessel disease and those with a history of liver or kidney disease should take perphenazine only after a thorough evaluation. Perphenazine should also be used cautiously when taken over a long period. Rarely should perphenazine be taken by pregnant or nursing women; it passes into the breastmilk and can cause drowsiness and adverse side effects in the infant.

Side effects

Serious or life-threatening side effects due to perphenazine are rare. However, if any of these occur, patients should contact their doctors or get immediate medical attention: seizures , irregular heartbeat, significant changes in blood pressure, muscle stiffness, weakness, pale skin color, and increased sweating. The treating doctor should be contacted immediately if any of these common side effects develop: rapid movements of the tongue, uncontrolled chewing movement, unusual amounts of lip smacking, and frequent movement of the arms or legs. The treating doctor should be contacted relatively soon if any of the following common side effects develop: reduced balance control, muscle spasms, restlessness, trembling, weakness in the limbs, blurred vision, and decreased night vision.

Less common side effects that need to be reported to the doctor include severe sunburn, skin rashes, and urination problems. Rare side effects that should be reported to the doctor include abdominal pain, muscle aches, joint aches, fever, chills, muscle weakness, and vomiting. Common but not serious side effects include constipation, drowsiness, decreased sweating, mouth dryness, and nasal congestion. Uncommon and not typically serious side effects include decreased sexual desire, increased susceptibility to sunburn, menstrual cycle changes, swelling or pain in the breasts, and weight gain.

Interactions

Combining perphenazine with drugs such as the antimalarials amodiaquine, chloroquine, and sulfa-doxine-pyrimethamine (Fansidar) can increase the concentrations within the body of theseantimalarials..

Perphenazine combined with barbiturates tends to lower the concentrations of perphenazine in the body. Combining perphenazine with clonidine (Cata-press), guanadrel (Hylorel), and guanethidine (Isme-lin) can produce dangerously low blood pressure.

Perphenazine should not be combined with alcohol, because alcohol increases the drug’s depressive effect on the central nervous system. Perphenazine inhibits the effects of levodopa in Parkinson’s patients when the two are combined. Lithium combined with perphenazine lowers the levels of both drugs.

KEY TERMS

Glaucoma —A group of eye diseases characterized by increased pressure within the eye significant enough to damage eye tissue and structures. If untreated, glaucoma results in blindness.

Psychosis —Severe state that is characterized by loss of contact with reality and deterioration in normal social functioning; examples are schizophrenia and paranoia. Psychosis is usually one feature of an overarching disorder, not a disorder in itself. (Plural: psychoses)

Perphenazine should not be combined with analgesics (pain killers) containing narcotics because of the combination increases depressive effects on the central nervous system. Orphenadrine (Norflex) combined with perphenazine can reduce the beneficial effects of perphenazine.

Resources

BOOKS

Consumer Reports Staff, eds. Consumer Reports Complete Drug Reference, 2002 ed. Denver: Micromedex Thomson Healthcare, 2001.

Ellsworth, Allan J. and others. Mosby’s Medical Drug Reference. 2001–2002. St.Louis: Mosby, 2001.

Hardman, Joel G., Lee E. Limbird, eds. Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 10th ed. New York: McGraw-Hill, 2001.

Mosby’s GenRx Staff. Mosby’s GenRx, 9th ed. St. Louis: Mosby, 1999.

Venes, Donald, and others, eds. Taber’s Cyclopedic Medical Dictionary, 19th ed. Philadelphia: F. A. Davis, 2001.

PERIODICALS

Rosenheck, R.A., D.L. Leslie, J. Sindelar, E.A. Miller, H. Lin, et al. “Cost-Effectiveness of Second Generation Antipsychotics and Perphenazine in a Randomized Trial of Treatment for Chronic Schizophrenia.” American Journal of Psychiatry 163 (2006): 2080–89.

WEB SITES

National Library of Medicine. National Institutes of Health. “Perphenazine.” http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682165.html

U.S. Food and Drug Administration. “Trilafon.” Drug information. http://www.fda.gov/cder/foi/label/2001/11213s22lbl.pdf

Mark Mitchell, MD
Emily Jane Willingham, PhD

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"Perphenazine." The Gale Encyclopedia of Mental Health. . Encyclopedia.com. 25 Sep. 2018 <http://www.encyclopedia.com>.

"Perphenazine." The Gale Encyclopedia of Mental Health. . Encyclopedia.com. (September 25, 2018). http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/perphenazine

"Perphenazine." The Gale Encyclopedia of Mental Health. . Retrieved September 25, 2018 from Encyclopedia.com: http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/perphenazine

Learn more about citation styles

Citation styles

Encyclopedia.com gives you the ability to cite reference entries and articles according to common styles from the Modern Language Association (MLA), The Chicago Manual of Style, and the American Psychological Association (APA).

Within the “Cite this article” tool, pick a style to see how all available information looks when formatted according to that style. Then, copy and paste the text into your bibliography or works cited list.

Because each style has its own formatting nuances that evolve over time and not all information is available for every reference entry or article, Encyclopedia.com cannot guarantee each citation it generates. Therefore, it’s best to use Encyclopedia.com citations as a starting point before checking the style against your school or publication’s requirements and the most-recent information available at these sites:

Modern Language Association

http://www.mla.org/style

The Chicago Manual of Style

http://www.chicagomanualofstyle.org/tools_citationguide.html

American Psychological Association

http://apastyle.apa.org/

Notes:
  • Most online reference entries and articles do not have page numbers. Therefore, that information is unavailable for most Encyclopedia.com content. However, the date of retrieval is often important. Refer to each style’s convention regarding the best way to format page numbers and retrieval dates.
  • In addition to the MLA, Chicago, and APA styles, your school, university, publication, or institution may have its own requirements for citations. Therefore, be sure to refer to those guidelines when editing your bibliography or works cited list.