Trifluoperazine: uses and side effects of this antipsychotic drug
This drug is part of the treatments sometimes used against the symptoms of schizophrenia.
Trifluoperazine is a drug that is prescribed to treat some manifestations of schizophrenia. This is because it has important effects on the mesolimbic pathways that regulate the release of dopamine. It is also a drug that is not marketed everywhere and is subject to medical prescription.
In this article we will see what is trifluoperazinehow it acts on the limbic system, what are its indications and side effects.
What is Trifluoperazine?
Trifluoperazine is a chemical compound of antidopaminergic reaction. That is, it acts as an antagonist of dopamine receptors, thus, it has potent tranquilizing, anxiolytic and antipsychotic effects.
Because of these effects, trifluoperazine is within the group of the typical antipsychoticsIt is also called conventional antipsychotics with neuroleptic effects (central nervous system depressants).
Broadly speaking, it is a drug that decreases the excitation of the electrical activity in the brain.
What is it used for and what disorders is it used for?
Trifluoperazine is prescribed to treat some manifestations of the diagnosis of schizophrenia and its main purpose is to reduce psychotic experiences. Because of its significant sedative action, it is commonly recommended in acute schizophrenia crises with intense anxiety and mania. It is also recommended for non-prolong-term use to treat anxiety conditions that have not responded to other medications.
This drug is available by prescription and is marketed under different names, depending on the country. Some of the most common are Cuait Trifluoperazine, Eskazine, Stelazine, Tristazine and Stelazine and its presentation as tablets for oral administration. In the case of Spain, it has ceased to be marketed since the beginning of 2018. However, there are some generic presentations and it is also distributed by import.
Mechanism of action.
Although this mechanism is not precisely defined, different researches have related the anti dopaminergic actions with the decrease of psychotic experiences. Antidopaminergic actions" are those that produce a blockade of postsynaptic receptors in the mesolimbic cortical pathways.
The latter is one of the brain's dopaminergic pathways that starts in the midbrain and ends in the limbic system (passing through the amygdala, hippocampus and prefrontal cortex, among other areas). The mesolimbic pathway is one of the pathways that has been significantly related to situations such as emotional regulation, motivation, emotional gratification and reward mechanisms.. The main neurotransmitter acting within this pathway is dopamine.
Because of its effects in terms of emotional and behavioral regulation, the activity of the mesolimbic pathway is associated with the behavioral and psychic manifestations of schizophrenia.. More specifically with the manifestations of what has been called "positive symptoms" or "psychosis", where experiences of hearing voices or depersonalization, among others, are very present.
There is a dopaminergic hypothesis that says that these latter experiences are related to a hyperactivity of the mesolimbic pathways in the brain, with which, drugs have been developed, such as trifluoperazine, which act as blockers of dopamine receptors. It is hoped that in the long term trifluoperazine may prevent further psychotic breaks.
Side effects and contraindications
The dopaminergic action not only has neuroleptic effects in reducing psychotic manifestations, but also has effects on other neuronal receptors and on other systems beyond the central nervous system, for example on the endocrine or metabolic system.
Within the central nervous system, and as trifluoperazine also impacts other pathways (not only the mesolimbic), it can produce some reactions such as drowsiness, dizziness, decreased alertness and responsiveness, photosensitivity and some visual disturbances.
In addition, the use of trifluoperazine may generate more serious adverse reactions such as constant involuntary motor agitationcombined with periods of extremely slow movements. In relation to other systems, such as the metabolic or endocrine systems, it may cause constipation, reduced sexual activity, hyperglycemia, among other reactions.
In the case of prescription or taking excessive doses, as well as in the case of abrupt withdrawal of the drug, convulsions, loss of consciousness, fever, tachycardia and hepatic failure have occurred in high doses, neuroleptic malignant syndrome, among other adverse reactions that can be fatal.
Its use is not recommended during pregnancy and lactation and should avoid mixing with other narcotics, anesthetics, sedatives and alcoholic beverages (otherwise it increases the likelihood of adverse reactions).
Older adults are especially sensitive to the effects of this drug, so special precautions are recommended in this case. It is especially contraindicated in the case of persons with dementia. (because it increases the risk of Cardiovascular accident and mortality), it is used only in case other pharmacological options have not worked and it is recommended not to prolong the treatment for more than 3 months. The same applies to people with glaucoma, angina pectoris and other associated medical conditions.
(Updated at Apr 13 / 2024)