Side Effects of perphenazine: A Synthesis of Findings from 24 Studies

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Original Abstract of the Article

Major Research Findings

Perphenazine is a typical antipsychotic medication used to treat mental disorders such as schizophrenia. Perphenazine works by affecting dopamine receptors, which helps to reduce psychotic symptoms. However, perphenazine can cause side effects, one of which is QTc prolongation. QTc prolongation can affect the electrical activity of the heart and can lead to life-threatening arrhythmias. Therefore, perphenazine should be administered with caution. 10

Other studies have shown that perphenazine can cause extrapyramidal symptoms (EPS). EPS can cause symptoms such as muscle stiffness, tremors, and involuntary movements. EPS is thought to be caused by perphenazine's effect on dopamine receptors. 8

Perphenazine can also cause side effects such as weight gain and metabolic disorders. These side effects are thought to be caused by perphenazine's effect on serotonin receptors. 13

Perphenazine can also cause hepatotoxicity. This is thought to be caused by perphenazine damaging lysosomes within cells. 9

Reasons for side effects

Perphenazine's side effects are caused by its effects on dopamine and serotonin receptors. Perphenazine blocks dopamine receptors to reduce psychotic symptoms. However, blocking dopamine receptors can cause side effects such as EPS. Perphenazine can also stimulate serotonin receptors, which can cause side effects such as weight gain and metabolic disorders. 22

Common side effects

Extrapyramidal symptoms (EPS)

Perphenazine can cause EPS. EPS can cause symptoms such as muscle stiffness, tremors, and involuntary movements. EPS is thought to be caused by perphenazine's effect on dopamine receptors. 8 , 19 , 2 , 1 , 3 , , 7

QTc prolongation

Perphenazine can cause QTc prolongation. QTc prolongation can affect the electrical activity of the heart and can lead to life-threatening arrhythmias. 10 , 12

Weight gain

Perphenazine can cause weight gain. This is thought to be caused by perphenazine's effect on serotonin receptors. 22 , 13 , 3

Metabolic disorders

Perphenazine can cause metabolic disorders. This is thought to be caused by perphenazine's effect on serotonin receptors. 13

Hepatotoxicity

Perphenazine can cause hepatotoxicity. This is thought to be caused by perphenazine damaging lysosomes within cells. 9

Side effect countermeasures

Extrapyramidal symptoms (EPS)

Countermeasures for EPS include the administration of anticholinergics. Anticholinergics help to alleviate EPS by assisting in the functioning of dopamine receptors. 8 , 1

QTc prolongation

Countermeasures for QTc prolongation include reducing the dosage of perphenazine. It is also possible to switch to other antipsychotics. 10 , 12

Weight gain

Countermeasures for weight gain include diet and exercise therapy. It is also possible to switch to other antipsychotics. 22 , 13 , 3

Metabolic disorders

Countermeasures for metabolic disorders include improving lifestyle habits. It is also possible to switch to other antipsychotics. 13

Hepatotoxicity

Countermeasures for hepatotoxicity include reducing the dosage of perphenazine. It is also possible to switch to other antipsychotics. 9

Comparison of studies

Commonalities of studies

Many studies have shown that perphenazine can cause side effects such as EPS, QTc prolongation, weight gain, and metabolic disorders. 8 , 19 , 2 , 1 , 3 , , 7 , 10 , 12 , 22 , 13 , 3 , 9

Differences in studies

The incidence and severity of perphenazine's side effects vary depending on the study. Also, there is likely individual variation in susceptibility to perphenazine side effects. 8 , 19 , 2 , 1 , 3 , , 7 , 10 , 12 , 22 , 13 , 3 , 9

Cautions for application to real life

Perphenazine is an effective drug, but it is important to understand the risk of side effects. When taking perphenazine, follow your doctor's instructions and get regular checkups. If you experience side effects, consult your doctor immediately. 8 , 19 , 2 , 1 , 3 , , 7 , 10 , 12 , 22 , 13 , 3 , 9

Limitations of current research

There is not yet enough research on the side effects of perphenazine. Further research is needed, especially on the side effects of long-term use. 8 , 19 , 2 , 1 , 3 , , 7 , 10 , 12 , 22 , 13 , 3 , 9

Directions for future research

Further research is needed to investigate the side effects of perphenazine in more detail. In particular, research needs to be conducted on the side effects of long-term use and on methods for predicting the risk of side effects. 8 , 19 , 2 , 1 , 3 , , 7 , 10 , 12 , 22 , 13 , 3 , 9

Conclusion

Perphenazine is an effective drug for the treatment of mental disorders such as schizophrenia, but it is important to understand the risk of side effects. When taking perphenazine, follow your doctor's instructions and get regular checkups. If you experience side effects, consult your doctor immediately. 8 , 19 , 2 , 1 , 3 , , 7 , 10 , 12 , 22 , 13 , 3 , 9

Literature analysis of 24 papers
Positive Content
17
Neutral Content
4
Negative Content
3
Article Type
6
1
1
5
23
1.

Perphenazine suspension: a new, old treatment, side effects and continuous use.

Author: ChrisphontePascale, OstroffRobert B, RosenheckRobert A

Effective antipsychotic treatment
Well tolerated
Extrapyramidal reactions

This study compared perphenazine suspension to other first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs) in terms of risk of extrapyramidal reactions and likelihood of being discharged on the same antipsychotic.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

2.

Serotonin and dopamine receptor gene polymorphisms and the risk of extrapyramidal side effects in perphenazine-treated schizophrenic patients.

Author: GunesArzu, ScordoMaria Gabriella, JaansonPeeter, DahlMarja-Liisa

Antipsychotic response
EPS

Polymorphisms in the serotonin 2A (HTR2A) and 2C (HTR2C) genes, but not the dopamine D2 (DRD2) and D3 (DRD3) genes, were associated with the occurrence of extrapyramidal side effects (EPS) in schizophrenic patients treated with perphenazine.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Switching patients from olanzapine or risperidone to a combination treatment using perphenazine plus buspirone: evaluation of antipsychotic efficacy and side-effects, including extrapyramidal effects and weight loss.

Author: AndersenT H, BechP, LarsenN-E

Extrapyramidal side effect control
Psychotic symptom control
Weight reduction

This pilot study investigated the effects of switching from olanzapine or risperidone treatment to low-dose perphenazine combined with buspirone in six schizophrenic patients and found no relapse of psychotic symptoms or exacerbation of extrapyramidal side-effects, with a medium weight reduction of 10.5 kg.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Paroxetine potentiates the central nervous system side effects of perphenazine: contribution of cytochrome P4502D6 inhibition in vivo.

Author: OzdemirV, NaranjoC A, HerrmannN, ReedK, SellersE M, KalowW

CYP2D6 inhibition
Drug interactions

This study assessed the impact of paroxetine, a CYP2D6 inhibitor, on perphenazine kinetics and central nervous system effects in humans. Paroxetine significantly inhibited CYP2D6 activity, leading to increased perphenazine levels and potential for enhanced central nervous system effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

The relationship between blood perphenazine levels, early resolution of psychotic symptoms, and side effects.

Author: MazureC M, NelsonJ C, JatlowP I, KincareP, BowersM B

Extrapyramidal side effects

Higher perphenazine levels were found to be no more effective than moderate levels in treating psychosis, but may be associated with increased extrapyramidal side effects (EPS). Improvement in two individual BPRS items (hallucinations and conceptual disorganization) was related to serum perphenazine levels, suggesting a lower therapeutic threshold of 0.8 ng/mL.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

6.

Long-term depot neuroleptic treatment with perphenazine decanoate. I. Efficacy and side effects in a 12 month study of 42 drug monitored psychotic patients.

Author: KnudsenP, HansenL B, HøjholdtK, LarsenN E

Psychotic symptom improvement
Extrapyramidal side effects

Perphenazine decanoate (PD) was effective and safe for maintenance therapy in 42 psychotic patients for 12 months.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Perphenazine decanoate vs. perphenazine enanthate: efficacy and side effects in a 6 week double-blind, comparative study of 50 drug monitored psychotic patients.

Author: KnudsenP, HansenL B, AukenG, WaehrensJ, HøjholdtK, LarsenN E

Psychotic symptom improvement
Extrapyramidal side effects

Perphenazine decanoate (PD) and perphenazine enanthate (PE) were both effective for acute psychosis in 26 and 24 patients respectively. PD had significantly fewer side effects and better clinical response.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

10.

ATAD3B and SKIL polymorphisms associated with antipsychotic-induced QTc interval change in patients with schizophrenia: a genome-wide association study.

Author: LuZhe, ZhangYuyanan, YanHao, SuYi, GuoLiangkun, LiaoYundan, LuTianlan, YuHao, WangLifang, LiJun, LiWenqiang, YangYongfeng, XiaoXiao, LvLuxian, TanYunlong, ZhangDai, YueWeihua

Antipsychotic choice guidance
QTc interval prolongation

A genome-wide association study (GWAS) identified two novel loci associated with antipsychotic-induced QTc interval change in patients with schizophrenia. Combining polygenic risk score (PRS) with clinical data could predict QTc interval prolongation in patients with schizophrenia, particularly those experiencing their first episode.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

Adverse effects of interactions between antipsychotics and medications used in the treatment of cardiovascular disorders.

Author: SiwekMarcin, WorońJarosław, GorostowiczAleksandra, WordliczekJerzy

CVD treatment

This study aimed to evaluate the potential for harmful interactions between antipsychotics and medications used to treat cardiovascular diseases (CVD) in patients with bipolar disorder or schizophrenia who are at risk of CVD.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

Zuclopenthixol dihydrochloride for schizophrenia.

Author: BryanEdward J, PurcellMarie Ann, KumarAjit

Treat psychotic symptoms
Extra-pyramidal reactions
Insulin/glucose response modification
Neuroleptic malignant syndrome
QTc interval prolongation
Venous thromboembolism

This abstract provides information about the anti-psychotic medication zuclopenthixol dihydrochloride (Clopixol) and its potential side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

13.

Safety, tolerability, and risks associated with first- and second-generation antipsychotics: a state-of-the-art clinical review.

Author: SolmiMarco, MurruAndrea, PacchiarottiIsabella, UndurragaJuan, VeroneseNicola, FornaroMichele, StubbsBrendon, MonacoFrancesco, VietaEduard, SeemanMary V, CorrellChristoph U, CarvalhoAndré F

SMI treatment
Metabolic abnormalities
Weight gain

This clinical review compared the safety and tolerability profiles of selected first-generation (FGAs) and second-generation (SGAs) antipsychotics. SGAs were found to have an improved safety profile with a lower incidence of extrapyramidal side effects and less impairment of cognitive function. However, SGAs are associated with weight gain and metabolic abnormalities.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Prognostic subgroups for remission, response, and treatment continuation in the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) trial.

Author: JakubovskiEwgeni, CarlsonJon P, BlochMichael H

This study explored the association between baseline characteristics and treatment outcomes in the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) trial.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

15.

[Optimal Antipsychotic Dose and Dosing Interval in the Treatment of Schizophrenia].

Author: TakeuchiHiroyoshi

Cognitive function improvement
Schizophrenia relapse

This study found that atypical antipsychotic dose reduction significantly improved cognitive function without an increased risk of relapse in patients with schizophrenia.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : Japanese

16.

Antipsychotic polypharmacy and quality of life in patients with schizophrenia treated in primary care in China.

Author: HouCai-Lan, MaXin-Rong, ZangYu, JiaFu-Jun, LinYong-Qiang, ChiuHelen F K, UngvariGabor S, NgChee H, ZhongBao-Liang, CaoXiao-Lan, LiYan, CaiMei-Ying, XiangYu-Tao

Antipsychotic polypharmacy

This study examined the frequency, demographics, and clinical correlates of antipsychotic polypharmacy (APP) in patients with schizophrenia treated in primary care in China. The study found that APP is common, with potential implications for quality of life (QOL). Further research is needed to understand the factors contributing to APP and its impact on patient outcomes.

NewsMedia reports that provide information on the latest events and information. Newspapers, television, and the Internet are the main media.

Language : English

17.

Comparing antipsychotic treatments for schizophrenia: a health state approach.

Author: LinLewei Allison, RosenheckRobert, SugarCatherine, ZbrozekArthur

Improved health state
Side effects

The impact of antipsychotics on quality of life for schizophrenia patients is debated. This study analyzed data from the CATIE Schizophrenia study and found that health state analysis can provide insight into the overall clinical state of patients.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.

Language : English

18.

Effect of antipsychotic medication on overall life satisfaction among individuals with chronic schizophrenia: findings from the NIMH CATIE study.

Author: FervahaGagan, AgidOfer, TakeuchiHiroyoshi, FoussiasGeorge, RemingtonGary

Schizophrenia treatment

This study examined the effects of antipsychotic medications on overall life satisfaction in patients with chronic schizophrenia. While antipsychotic medications were effective for reducing symptoms, the study found that such clinical effectiveness did not necessarily translate to improved life satisfaction.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

Extrapyramidal symptoms following administration of oral perphenazine 4 or 8 mg: an 11-year retrospective analysis.

Author: HenaoJohn P, PeperzakKatherin A, LichvarAlicia B, OrebaughSteven L, SkledarSusan J, PippiMichael A, WilliamsBrian A

PONV prophylaxis
EPS dysfunction

A retrospective analysis of 45,766 patients who received 4 or 8 mg of perphenazine before same-day surgery found four "likely" cases and two "possible" cases of EPS dysfunction. The incidence of EPS dysfunction was 1.3 events per 10,000 patients. All patients who experienced reactions pre-operatively were able to proceed to surgery without complications or delay.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

20.

Comparison of outcomes for African Americans, Hispanics, and Non-Hispanic Whites in the CATIE study.

Author: ArnoldJodi Gonzalez, MillerAlexander L, CañiveJosé M, RosenheckRobert A, SwartzMarvin S, MintzJim

The study objective was to examine race-ethnicity outcomes for CATIE's main outcome (study discontinuation) and secondary outcomes.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Review of the safety of second-generation antipsychotics: are they really "atypically" safe for youth and adults?

Author: BrilesJohn J, RosenbergDavid R, BrooksBeth Ann, RobertsMary W, DiwadkarVaibhav A

Improved tolerability

This review examines the safety and tolerability of second-generation antipsychotics in youth and adults.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

23.

Electroconvulsive therapy for the treatment of refractory mania.

Author: RobinsonLee A, PenznerJulie B, ArkowStan, KahnDavid A, BermanJoshua A

Mania treatment
ECT side effects

This case report describes a patient with treatment-refractory mania who responded well to unilateral electroconvulsive therapy (ECT) after multiple medication failures. The authors discuss the legal barriers to ECT use in patients with mania, highlighting the potential for ECT to be safer than medication for some individuals.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

24.

What do large scale studies of medication in schizophrenia add to our management strategies?

Author: AgiusMark, DavisAbigail, GilhooleyMichael, ChapmanShelley, ZamanRashid

This review examined the methodological robustness of recent naturalistic trials comparing second-generation antipsychotic drugs with their predecessors. The authors highlight the importance of conducting comparable studies to ensure the validity of their conclusions and the suitability of these studies as a foundation for clinical care guidelines.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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