Chlorpromazine
A low-potency phenothiazine antipsychotic used for schizophrenia, mania, severe nausea and vomiting, and intractable hiccups.
Drug card
- How it works
- Blocking dopamine D2 receptors in the brain
- Used for
- Schizophrenia and other psychoses
- Mania in bipolar disorder
- Severe nausea and vomiting
- Intractable hiccups
- Known for
- Drowsiness
- Dizziness on standing (orthostatic hypotension)
- Cholestatic jaundice
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does chlorpromazine work?
Chlorpromazine, a phenothiazine, blocks postsynaptic dopamine receptors in limbic and cortical areas, easing psychosis, and in the chemoreceptor trigger zone, preventing vomiting. It also blocks α-adrenergic receptors strongly and has weaker anticholinergic, antihistamine and antiserotonin actions; its autonomic effects cause vasodilation, low blood pressure and tachycardia.
Like other first-generation antipsychotics: First-generation antipsychotics block dopamine D2 receptors. Blockade in the mesolimbic pathway suppresses hallucinations and delusions, and in the chemoreceptor trigger zone it stops vomiting; blockade in the basal ganglia causes extrapyramidal effects, and in the anterior pituitary it lifts dopamine's brake on prolactin. Low-potency drugs such as chlorpromazine also block α1, muscarinic and H1 receptors.
Uses
What is chlorpromazine used for?
- Schizophrenia and other psychoses
- Mania in bipolar disorder
- Severe nausea and vomiting
- Intractable hiccups
- Severe agitation or anxiety, short term
Side effects
Side effects of chlorpromazine
- DrowsinessKnown for
- Dizziness on standing (orthostatic hypotension)Known for
- Cholestatic jaundiceKnown forSerious
- Dry mouth, constipation and urinary retention
- Dystonia and parkinsonism (extrapyramidal effects)
- Tardive dyskinesia with long-term useSerious
- Neuroleptic malignant syndromeSerious
- Raised prolactin: breast swelling and milk production
- Low white cell count, even agranulocytosisSerious
- Sensitivity to sunlight (photosensitivity)
- Deposits in the lens and cornea with long-term use
- Skin pigmentation with long-term high doses
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- Do not use in coma or when large amounts of alcohol, barbiturates or opioids have been taken.
- Use with care in liver disease, and test liver function if fever with flu-like symptoms appears.
- Advise avoiding strong sunlight because of photosensitivity.
- It can lower the seizure threshold: take care in epilepsy.
Good to know: A low-potency phenothiazine with broad receptor block; beyond psychosis it treats severe nausea and intractable hiccups.
Remember it
A way to remember it
TEMPO
- T
- Tardive dyskinesia
- E
- Extrapyramidal effects
- M
- Malignant syndrome (neuroleptic)
- P
- Prolactin raised
- O
- Orthostatic hypotension
Written for biofideX
Its class
First-generation antipsychotics
Other first-generation antipsychotics with a card:
Easily mixed up with second-generation antipsychotics and dopamine antagonist antiemetics.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
- Chlorpromazine hydrochloride: label (DailyMed)
- Chlorpromazine 25 mg tablets: SmPC (emc)
- Chlorpromazine (NCI Thesaurus)
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Psychosis, mood and ADHD
Chlorpromazine is one of 9 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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