Perazine is a 1st-generation, mid-potency neuroleptic. It is used to treat psychotic syndromes. In addition to schizophrenia, psychosis, anxiety disorders, delusions, and personality disorders are treated with the drug. Perazine has a sedative and antipsychotic effect by inhibiting certain neurotransmitters in the central nervous system in their action. The use and dosage of the drug must be discussed with the attending physician and should be individualized to the patient. When taken, certain side effects are possible, such as cardiac arrhythmias, dry mouth, and Parkinson’s-like symptoms.
What is perazine?
Perazine is a drug that is marketed under the trade name Taxilan. It belongs to the group of drugs called phenothiazines. Phenothiazines are substances that are poorly soluble in water. They are used not only as drugs but also as insecticides or dyes. Pharmacologically active phenothiazines are very similar in chemical structure to the first neuroleptic discovered, chlorpromazine. Perazine is a moderately potent neuroleptic and came on the market in the 1960s. The active ingredient is available in varying dosages. Other ingredients in the drug include cellulose, copovidone, sodium salt, magnesium, and iron.
Pharmacological action
Neuroleptics have sedative and antipsychotic effects on the human organism. They can be divided in terms of their generation and potency. Perazine, like melperone or zuclopenthixol, belongs to the mid-potent neuroleptics of the 1st generation. Psychotic states can be attributed primarily to the mechanisms of action of certain neurotransmitters in the brain. Therefore, the drug is also effective in the central nervous system. Perazine is a so-called dopamine antagonist. It binds to the receptor for dopamine in the brain and thus prevents dopamine from docking. As a result, the action of dopamine is inhibited. Therefore, the drug affects the effect of the neurotransmitter on the human psyche. By inhibiting dopamine, signal transmission to nerve endings is restricted. As a result, feelings such as tension, anxiety and restlessness decrease. At the same time, hallucinations and delusions are limited.
Medical application and use
Perazine is used in medicine to treat acute psychotic syndromes. Thus, it finds application in delusions, ego disorders, and hallucinations. Other indications of the drug are the so-called catatonic syndrome, as well as exogenous and endogenous psychoses. Catatonic syndrome is a psychomotor syndrome that can occur in connection with mental illnesses such as depression or schizophrenia. Behavioral, emotional, and motor symptoms are characteristic. Other indications include manic disorders and agitation states such as severe aggressiveness. Perazine should always be taken as directed by the treating physician. Dose adjustment on one’s own may lead to undesirable risks and side effects and should therefore be avoided. The form of administration, duration of use, and dosage should be individualized to the patient and their disease burden. Perazine has an antipsychotic effect that reaches its maximum in some cases only after one to three weeks of use. In contrast, the depressant effect on psychomotor function begins immediately. Strongly fluctuating dosages should be avoided. Particularly after long-term use, the drug should not be discontinued abruptly.
Risks and side effects
People who are allergic to perazine must not take the drug. In addition, the drug must not be prescribed if the patient suffers from severe damage to the blood cells or bone marrow. Under certain disease conditions such as pre-damage of the heart, a glaucoma, severe liver disease, enlargement of the prostate, narrowing of the gastric outlet and others, the drug can be taken in principle. However, special caution is required in these cases. While taking Perazine certain side effects may occur. Common negative effects include sedation, tightening of the tongue or pharyngeal muscles, twisting of the eyes, and jaw muscle spasms. Furthermore, Parkinson’s syndrome may occur.This is characterized by stiffness, lack of movement and tremor. If the latter is the case, the dose of the drug should be reduced. Especially at the beginning of treatment, a drop in blood pressure can be observed. The drug should therefore not be administered if the baseline pressure is severely depressed. In some cases, changes in the blood count can also be observed. Dry mouth, weight loss, sweating, increased thirst and changes in intraocular pressure may be possible consequences, especially at high doses. Other side effects such as sleep disturbances, general restlessness, altered sex drive, breathing difficulties and cardiac arrhythmias occur rather rarely. Very rarely, treatment with perazine can lead to the life-threatening malignant neuroleptic syndrome. However, most side effects can be avoided by dosing that is individualized to the patient and discussed with the physician. The drug should not be administered to children under 16 years of age. Perazine should further not be taken in the first trimester of pregnancy or during lactation.
