Trifluoperazine & Tardive Dyskinesia
Pharmaceutical conglomerate GlaxoSmithKline (formerly Smith, Kline & French) was the first U.S. company to market antipsychotic drugs. The first one, introduced in 1954, was chloropromazine, which was sold under the brand name Thorozine. The second was known as trifluoperazine, which is still sold as Stelazine.
Both of these drugs are ultimately derived from a chemical compound developed in Germany in the 1880s known as phenothiazine. Like most first-generation antipsychotic medications, this substance is also found in an insecticide sold by DuPont Chemicals. Of the two, trifluoperazine is by far the more potent. It is estimated that compared to a similar dose of chloropromazine, trifluoperazine delivers as much as 20 times the medication.
Indications and Delivery
Trifluoperazine is considered a "typical," or "conventional" medication for the treatment of schizophrenia. It addresses symptoms that include paranoia, excessive apathy and inappropriate emotional response as well as anxiety and auditory hallucinations. As is the case in other types of neuroleptic medications, it is a dopamine antagonist, or inhibitor. Essentially, trifluoperazine interrupts signals from the brain to other parts of the body, specifically those involved in emotional responses. Historically, it has been used in conjunction with the antidepressant MAOI in order to counter the stimulant effect of the medication. It has also been combined with amobarbital for the regulation of sleep. These "drug cocktails" were sold under the brand names Jatrosom © and Jalonac © respectively, but have been discontinued.
Trifluoperazine is also used to treat dementia. However, this use of the drug has not been approved by the FDA for use in older adults, who run the risk of death during treatment. In fact, a recent British study has shown that patients treated for Alzheimer's disease using trifluoperazine and other types of antipsychotic medications experienced worsening of their symptoms. In April 2008, the BBC News Service reported that neuroleptics provided no benefit for patients with mild behavioral problems, but were associated with a marked deterioration in verbal skills.
Unlike other antipsychotic medications, trifluoperazine may be taken orally in a pill, capsule or as a liquid, or injected into muscle tissue.
Side Effects
As is the case with other antipsychotic medications, trifluoperazine is strongly implicated in the development of tardive dyskinesia, a movement disorder that affects primarily the facial muscles, but can also affect the extremities and the torso. Rates of tardive dyskinesia reported among patients on this medication is estimated to be as much as 4 percent. Because tardive dyskinesia rates for patients on trifluoperazine are high and symptoms tend to be severe, increasing numbers of psychiatrists are abandoning its use.
Because it is chemically similar to chloropromazine, patients experience many of the same symptoms, including drymouth, tremors and constipation as well as dystonia or symptoms similar to Parkinson's disease. Particularly disturbing are reports of serious liver damage in some patients.
It is not currently known what affects trifluoperazine may have on a fetus, although it is known that the medication can be passed to a nursing child through a mother's breast milk.
In a 2008 letter to the editor of the Journal of Neuropsychiatry and Clinical Neuroscience, a team of researchers from India reported severe withdrawal symptoms when a patient's treatment with trifluoperazine was discontinued. The patient, age 78, was being treated for clinical depression. Each time the patient stopped taking the medication, he experienced muscular weakness, agitation and insomnia. Despite treatment with other medications, he was unable to refrain from taking trifluoperazine. The letter also noted that the man had a severe nicotine dependence, which may have influenced the withdrawal symptoms.
© 2010 TardiveDyskinesia.com Last Modified Friday, April 23rd, 2010
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