WARNING

Chlorpromazine is an antipsychotic medication used to treat conditions like schizophrenia and bipolar disorder. While effective, it carries several potential risks and side effects:

• Sedation: It can cause drowsiness and sedation, impairing alertness and coordination.
• Extrapyramidal symptoms (EPS): These include involuntary muscle movements such as tremors, rigidity, and restlessness (akathisia).
• Tardive dyskinesia: A potentially irreversible condition characterized by repetitive, involuntary movements, especially of the face and tongue.
• Neuroleptic malignant syndrome (NMS): A rare but serious reaction characterized by high fever, muscle rigidity, and mental status changes.
• Anticholinergic effects: Dry mouth, blurred vision, constipation, and urinary retention can occur due to its anticholinergic properties.
• Cardiovascular effects: Chlorpromazine can cause orthostatic hypotension (a sudden drop in blood pressure when standing), potentially leading to dizziness or fainting.
• Endocrine effects: It may disrupt hormone levels, causing menstrual irregularities and breast enlargement (especially in males).
• Metabolic effects: Weight gain, elevated blood sugar levels, and dyslipidemia (abnormal cholesterol levels) are possible.
• Liver effects: Rarely, it may cause liver damage or jaundice.
• Blood disorders: It can lower the white blood cell count, increasing susceptibility to infections.

It’s important to use chlorpromazine under medical supervision to monitor for these potential risks and manage any adverse effects that may arise.

Why is this medication prescribed?

Chlorpromazine is prescribed primarily for the treatment of various mental health conditions, including:

• Schizophrenia: It helps alleviate symptoms such as hallucinations, delusions, and disorganized thinking.
• Bipolar disorder: It can help manage episodes of mania and stabilize mood swings.
• Severe anxiety: In some cases, chlorpromazine may be used to reduce severe anxiety symptoms.

Chlorpromazine works by affecting the balance of certain neurotransmitters in the brain, particularly dopamine and serotonin, which are involved in regulating mood, behavior, and perception.

How should this medicine be used?

Here’s how it is generally used:

• Dosage: The dosage of chlorpromazine varies based on the condition being treated, the severity of symptoms, and individual response to the medication. It’s important to follow the dosage instructions provided by the prescribing doctor or pharmacist.
• Administration: Chlorpromazine is typically taken orally in the form of tablets or liquid. It may also be administered intramuscularly in certain situations, such as during acute episodes where rapid sedation is needed.
• Timing: It is usually taken 2-4 times daily, with or without food. Consistency in timing and adherence to the prescribed schedule are important for maintaining therapeutic levels in the blood.
• Duration: The duration of treatment with chlorpromazine depends on the condition being treated and individual response. It is generally used as part of a comprehensive treatment plan that may include therapy and other medications.
• Monitoring: Regular follow-up visits with the doctor are necessary to monitor the response to chlorpromazine, adjust the dosage if needed, and manage any potential side effects or complications.
• Discontinuation: It’s important not to stop taking chlorpromazine suddenly without consulting a doctor, as this can lead to withdrawal symptoms or a recurrence of symptoms.

Overall, chlorpromazine should only be used under the supervision of a healthcare provider who can monitor its effectiveness and manage any potential risks or side effects.

Other uses for this medicine

• Nausea and vomiting: It can be used to control nausea and vomiting, particularly in hospitalized patients or those undergoing chemotherapy.
• Agitation and aggression: Chlorpromazine may be used to calm agitated or aggressive behavior, especially in psychiatric emergencies.
• Hiccups: In some cases, chlorpromazine is prescribed to alleviate persistent hiccups that do not respond to other treatments.

What special precautions should I follow?

When taking chlorpromazine, it’s important to observe the following precautions to ensure safe and effective use:

• Allergies: Inform your doctor if you have any allergies to chlorpromazine or any other medications.
• Medical conditions: Notify your doctor about any medical conditions you have, especially:
  • Liver or kidney disease
  • Heart disease or history of heart problems
  • Seizures or epilepsy
  • Glaucoma
  • Enlarged prostate
  • Thyroid disorders
• Pregnancy and breastfeeding: Chlorpromazine should be used cautiously during pregnancy only if the potential benefits outweigh the risks. It may pass into breast milk, so breastfeeding should be discussed with your doctor.
• Children and elderly: Use caution when prescribing chlorpromazine to children and elderly patients, as they may be more sensitive to its effects.
• Interactions: Inform your doctor about all medications, vitamins, and herbal supplements you are taking, as chlorpromazine can interact with certain drugs, including other antipsychotics, antidepressants, and medications that affect heart rhythm.
• Alcohol and other substances: Avoid alcohol and limit the use of other substances that can cause drowsiness or dizziness when taking chlorpromazine, as it can enhance these effects.
• Driving and operating machinery: Chlorpromazine may impair your ability to perform tasks requiring alertness and coordination, so avoid driving or operating machinery until you know how it affects you.
• Sun exposure: Chlorpromazine can make you more sensitive to sunlight. Use sunscreen and wear protective clothing when outdoors to prevent sunburn.
• Regular monitoring: Your doctor may need to monitor your blood pressure, heart rate, and blood tests periodically while you are taking chlorpromazine.

Following these precautions helps minimize the risk of adverse effects and ensures that chlorpromazine is used safely and effectively for its intended purposes. Always consult your healthcare provider if you have any concerns or questions about its use.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with chlorpromazine. However, maintaining a healthy diet and staying hydrated can support overall health and well-being, which is important when taking any medication.

What should I do if I forget a dose?

If you forget to take a dose of chlorpromazine, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Chlorpromazine, like all medications, can cause a range of side effects. These can vary in severity and frequency among individuals. Common side effects of chlorpromazine include:

• Sedation and drowsiness: Feeling sleepy or drowsy is a common side effect, especially when starting the medication or when the dosage is increased.
• Dry mouth: Decreased saliva production can lead to a dry sensation in the mouth.
• Blurred vision: Temporary blurring of vision or difficulty focusing may occur.
• Constipation: Slowed bowel movements can result in constipation.
• Urinary retention: Difficulty urinating or decreased urine output may occur.
• Weight gain: Some people may experience weight gain while taking chlorpromazine.
• Orthostatic hypotension: A sudden drop in blood pressure upon standing, which can cause dizziness or lightheadedness.
• Extrapyramidal symptoms (EPS): These include involuntary movements such as tremors, muscle stiffness (rigidity), restlessness (akathisia), and tardive dyskinesia (repetitive, involuntary movements of the face and body).
• Endocrine effects: Chlorpromazine can disrupt hormone levels, leading to menstrual irregularities, breast enlargement (especially in males), and changes in libido.
• Neuroleptic malignant syndrome (NMS): A rare but potentially life-threatening reaction characterized by fever, muscle rigidity, altered mental status, and autonomic dysfunction.
• Liver effects: Elevated liver enzymes or, rarely, liver damage.
• Blood disorders: Chlorpromazine can lower white blood cell count, increasing susceptibility to infections, and occasionally cause agranulocytosis (a severe decrease in white blood cells).
• Allergic reactions: Rarely, allergic reactions such as rash, itching, or swelling can occur.

It’s important to note that not everyone experiences these side effects, and their severity can vary. Always discuss any concerns or unusual symptoms with your healthcare provider, as they can provide guidance on managing side effects or adjusting your treatment plan if necessary.

What should I know about storage and disposal of this medication?

Storage and Disposal of Chlorpromazine:

• Storage: Store chlorpromazine tablets or liquid at room temperature away from moisture and heat. Avoid storing it in the bathroom. Keep it out of reach of children and pets.
• Disposal: Dispose of unused or expired chlorpromazine properly according to local regulations or guidelines. Do not flush medications down the toilet unless instructed to do so. Contact your pharmacist or local waste disposal company for proper disposal methods.

In case of emergency/overdose

• Symptoms of overdose: Signs of overdose may include extreme drowsiness, confusion, agitation, hallucinations, seizures, severe dizziness or fainting, fast or irregular heartbeat, and difficulty breathing.
• What to do: If you suspect an overdose or someone has accidentally ingested chlorpromazine:
  • Call emergency services (911 in the US) immediately.
  • Provide as much information as possible, including the amount ingested and when it was taken.
  • Do not try to induce vomiting unless instructed by medical personnel.
  • If possible, have the medication packaging or bottle available for identification.

What other information should I know?

• Monitoring: Regular monitoring of your condition and response to chlorpromazine is important. Attend follow-up appointments as scheduled.
• Avoid abrupt changes: Avoid sudden changes in dosage or discontinuation of chlorpromazine without consulting your doctor, as it can lead to withdrawal symptoms or a worsening of symptoms.
• Medical ID: If you are taking chlorpromazine long-term or have a history of severe reactions to medications, consider wearing a medical alert bracelet or carrying an ID card indicating the medication you are taking.
• Inform healthcare providers: Inform all healthcare providers involved in your care (including dentists and specialists) that you are taking chlorpromazine. This helps them make informed decisions about your treatment.
• Interactions: Be cautious with other medications, including over-the-counter drugs and herbal supplements, as they can interact with chlorpromazine. Always check with your doctor or pharmacist before starting new medications.
• Driving and activities: Chlorpromazine can cause drowsiness, dizziness, or blurred vision, which may impair your ability to perform tasks such as driving. Avoid driving or operating machinery until you know how chlorpromazine affects you.
• Sun exposure: Chlorpromazine can increase sensitivity to sunlight. Use sunscreen and protective clothing when outdoors to prevent sunburn.
• Pregnancy and breastfeeding: Discuss the risks and benefits of chlorpromazine with your doctor if you are pregnant, planning to become pregnant, or breastfeeding.

By following these guidelines and staying informed about your medication, you can maximize the benefits of chlorpromazine while minimizing potential risks and complications. Regular communication with your healthcare provider is essential for safe and effective use of this medication.