Main Research Findings

Prochlorperazine is a medication commonly used for treating nausea and vomiting. It has also been studied for its effects on migraine headaches and its potential as an antipsychotic. However, several studies have highlighted the potential for prochlorperazine to cause significant side effects, particularly in children. 7 found that promethazine, prochlorperazine, and metoclopramide, all antiemetics, are commonly used in children, but can lead to potentially dangerous side effects. Research also suggests that prochlorperazine may cause dystonic reactions in children, particularly when used for headache treatment. 16 notes that the incidence of dystonic reactions to both metoclopramide and prochlorperazine in children has not been well studied. Additionally, 20 reports a case of a child experiencing extrapyramidal effects that mimicked meningitis after taking prochlorperazine. These findings indicate that caution is needed when using prochlorperazine in children, particularly given the lack of comprehensive research on its effects in this population.

Reasons for Side Effects

Prochlorperazine is a phenothiazine-class antipsychotic drug that works by blocking dopamine receptors in the brain. Dopamine is a neurotransmitter crucial for regulating movement, emotions, and thought. By blocking dopamine receptors, prochlorperazine disrupts these functions, which can lead to various side effects, particularly those affecting the nervous system.

Common Side Effects

Extrapyramidal Symptoms (EPS)

Extrapyramidal symptoms are a common side effect of prochlorperazine and other antipsychotics. These symptoms involve involuntary movements and muscle spasms. 16 points out the possibility of dystonic reactions in children treated with prochlorperazine or metoclopramide for headache. 20 highlights a case of prochlorperazine inducing extrapyramidal effects resembling meningitis in a child. 4 describes a pregnant patient who developed hemidystonia (spasms on one side of the body) after taking prochlorperazine, initially being misdiagnosed with a stroke. 3 reports on an 11-year-old boy who experienced a dystonic reaction resembling Bell's palsy after taking prochlorperazine. These studies demonstrate that prochlorperazine can cause various EPS, highlighting the need for cautious use, especially in children and individuals with preexisting neurological conditions.

Drowsiness

Drowsiness is a frequent side effect of prochlorperazine, often occurring in 60-70% of patients, as reported in 14 . This is attributed to prochlorperazine's effect on the central nervous system, potentially impacting alertness and concentration.

Gastrointestinal Symptoms

Prochlorperazine can lead to digestive issues such as stomach upset, constipation, or diarrhea. These side effects are often linked to prochlorperazine's ability to slow down gastrointestinal motility.

Other Side Effects

Besides EPS, drowsiness, and gastrointestinal issues, prochlorperazine may also cause skin reactions, visual disturbances, changes in heart rate, and weight gain. These effects are thought to be caused by prochlorperazine's influence on various organs and tissues.

Countermeasures for Side Effects

Extrapyramidal Symptoms

Anticholinergic medications are often used to manage extrapyramidal symptoms caused by prochlorperazine. These drugs help to reduce muscle spasms. 3 reports that intravenous diphenhydramine successfully resolved a dystonic reaction within 5 minutes in a child. 18 found that extrapyramidal symptoms like dyskinesia often subside naturally upon discontinuation of prochlorperazine, but also highlighted the use of intramuscular orphenadrine for immediate relief. While anticholinergics can be beneficial, they may not be suitable for everyone, particularly elderly patients or those with heart conditions. Therefore, it is critical to consult a doctor to discuss the best treatment strategy for prochlorperazine-related EPS.

Drowsiness

Drowsiness usually subsides within a few days after starting prochlorperazine. However, if drowsiness persists or is severe, adjusting the dosage or discontinuing the medication may be necessary. It's important to avoid driving or operating machinery if drowsiness occurs.

Gastrointestinal Symptoms

Treating gastrointestinal side effects from prochlorperazine often involves medication targeted at specific symptoms. For example, antacids can be used for stomach upset, laxatives for constipation, and antidiarrheals for diarrhea.

Other Side Effects

Treating other side effects of prochlorperazine varies depending on the specific issue. Skin reactions might be managed with steroid creams, visual disturbances require an ophthalmologist consultation, changes in heart rate may necessitate evaluation by a cardiologist, and weight gain can be addressed through dietary modifications.

Comparison Between Studies

Commonalities in Research

Across multiple studies, it is consistent that prochlorperazine can cause various side effects. The risk of extrapyramidal symptoms appears higher in children, requiring close monitoring. Additionally, drowsiness and gastrointestinal symptoms are frequently reported side effects.

Differences in Research

While studies agree on the potential for prochlorperazine to cause side effects, the specific incidence and types of side effects can vary. Factors such as age, gender, underlying conditions, dosage, and duration of treatment may contribute to these differences. Additionally, variations in research methodology and study populations can influence the observed results.

Cautions for Real-Life Application

Prochlorperazine can effectively treat nausea and vomiting, but its potential for side effects should not be overlooked. The risk of extrapyramidal symptoms is particularly concerning in children. Always consult with a doctor before starting prochlorperazine, and be sure to inform them of any existing health conditions. If you experience any unusual side effects while taking prochlorperazine, seek immediate medical attention.

Limitations of Current Research

Research on the side effects of prochlorperazine is still limited, especially concerning long-term effects. Further investigations are needed to better understand the long-term consequences of prochlorperazine use. Additionally, more research is required to fully comprehend the interactions between prochlorperazine and other medications.

Future Research Directions

To better understand the side effects of prochlorperazine, further research is needed. This includes long-term studies, investigations into drug interactions, and studies exploring the impact of individual differences on side effects. Developing safer alternatives to prochlorperazine is also an important area of focus for future research.

Conclusion

Prochlorperazine remains a valuable medication for treating nausea and vomiting, but its potential for side effects, especially in children, should not be ignored. It is essential to consult with a doctor before taking prochlorperazine and to be aware of potential side effects. If you experience any unexpected side effects while taking this medication, seek medical advice promptly.