Active Ingredients

Perphenazine – Effect, Application & Risks


The active ingredient perphenazine is a highly potent neuroleptic . It is used to treat delusions , hallucinations and psychosis .

What is perphenazine?

Perphenazine is part of the phenothiazine drug group . The active ingredient was developed in the 1950s.

It came onto the market in 1957 and was sold in Germany as a mono-preparation under the trade name Decentan®.

Today, perphenazine is used less often because more modern neuroleptics are now available.

Pharmacological action

Perphenazine is primarily effective in psychoses. In most cases, these are caused by disturbances in the metabolism of the brain . It is believed that these disorders are responsible for increased excitability in different areas of the brain. These active centers produce restlessness , fears and delusions , for example . The neurotransmitter dopamine plays an important role in this.

Perphenazine is classified as a neuroleptic, which has a dampening effect on the human nervous system . It is one of the phenothiazines that have the effect of classic neuroleptics. In this way, the drug influences the interaction of the different nerve cells and their interconnections. Perphenazine acts as an antagonist to dopamine, whose binding sites are blocked by it.

Perphenazine acts not only strongly, but also quickly. Its dopamine-inhibiting effect reduces symptoms caused by psychosis, as well as nervousness and restlessness. Animal experiments showed stronger effects of perphenazine than chlorpromazine . The neuroleptic mode of action can be compared to haloperidol .

If perphenazine is used in higher doses, the messenger substances adrenaline and histamine , which influence the autonomic nervous system , are also inhibited . In this way, movement disorders can be reduced, which are among the symptoms of schizophrenic psychosis.

In addition, the neuroleptic has an effect on the messenger substance acetylcholine . This neurotransmitter is important for muscle movement . Muscle twitching that occurs during psychotic episodes can be reduced by exposure to perphenazine .

The influence on acetylcholine also stimulates the activity of the intestines and the flow of saliva . For this reason, the drug is also considered effective against nausea and vomiting .

Perphenazine bioavailability is 40 percent, while the plasma half-life is between 8 and 12 hours. Metabolism of the neuroleptic takes place via the liver .

Medical Application & Use

The main area of ​​application of perphenazine is the treatment of psychotic disorders such as acute psychoses. The neuroleptic has a soothing effect on strong mood swings that occur in the context of mania , hallucinations and delusions. These usually come about as a result of a psychotic episode.

In addition, perphenazine is used to relieve pronounced muscle twitching during an acute attack of schizophrenia. Schizophrenia is one of the most common forms of psychosis. Since the neuroleptic also has calming properties, it can also be used to treat nervousness.

Perphenazine is also used for nausea and vomiting, where it is given as an alternative. This means that other means to this end were previously ineffective.

The drug is administered by taking tablets or drops. It can also be administered as an injection solution in an ampoule. The recommended dose of perphenazine is 4 to 8 milligrams given up to three times a day. The agent is also suitable for long-term therapy, which, however, increases the risk of tardive dyskinesia .

Risks & side effects

Adverse side effects may occur when using perphenazine . The most common side effects include drowsiness , difficulty sleeping , lightheadedness , fatigue , dizziness , restlessness, dyskinesia (involuntary head movements), jerky tongue protrusion, difficulty moving, muscle stiffness , involuntary facial movements, tremors and sedentary lifestyle.

Other frequently occurring side effects are orthostatic regulation disorders of the circulatory system , cardiac arrhythmia , increased heartbeat , low blood pressure , an increase in the prolactin level in the blood , breast tension , menstrual cycle disorders and milk flow, bronchial asthma , impotence and orgasm disorders.

In some patients, a malignant neuroleptic syndrome sets in during perphenazine therapy , which can assume life-threatening proportions. It becomes noticeable through muscular rigidity, tachycardia, circulatory collapse , fever , high blood pressure and clouding of consciousness . Even a fall into a coma is possible. At the beginning of the treatment, there are sometimes muscle cramps in the arms, neck, mouth and face, which in turn affects facial expressions .

If the patient is hypersensitive to perphenazine or other phenothiazines, the drug must not be used. The same applies after acute poisoning with alcohol , sleeping pills or painkillers .

Careful consideration of treatment with perphenazine by the doctor is required if the patient has severe liver dysfunction , previous heart damage, blood and bone marrow disorders , breast cancer , a tumor in the pituitary gland , orthostatic circulatory disorders, asthma, persistent breathing difficulties , depression or narrowing of the gastrointestinal tract intestinal tract suffers. The same applies to the presence of seizure disorders such as epilepsy . If the thyroid gland is overactive , the doctor must carefully monitor the patient.

If perphenazine administration is considered during pregnancy , it is important for the doctor to weigh the benefits and risks of treatment. Animal experiments showed that the active substance was harmful to the child, so that the drug should only be taken in exceptional cases. Because perphenazine also passes into breast milk and has a harmful effect on the child, breastfeeding must be avoided during therapy.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.