side effects, dosage, reviews, how to take & discontinue, uses, pros & cons, and more
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Table of Contents (hide)
- 1. Other brand names & branded generic names1
- 2. FDA Approved Uses of Thorazine (chlorpromazine)
- 3. Off-Label Uses of Thorazine (chlorpromazine)
- 4. Thorazine’s pros and cons
- 5. Thorazine’s (chlorpromazine) Side Effects
- 6. Interesting Stuff Your Doctor Probably Won’t Tell You about Thorazine (chlorpromazine HCl)
- 7. Thorazine’s (chlorpromazine) Dosage and How to Take Thorazine
- 8. How Long Thorazine (chlorpromazine) Takes to Work
- 9. How to Stop Taking Thorazine (chlorpromazine)
- 10. Thorazine’s (chlorpromazine) Half-Life & Average Time to Clear Out of Your System
- 11. Days to Reach a Steady State
- 12. Shelf Life
- 13. How Thorazine (chlorpromazine) Works
- 14. Comments
- 15. Thorazine Ratings, Reviews, & Other Sites of Interest
- 16. Bibliography
|US brand name: Thorazine|
|Generic name: chlorpromazine|
Other Forms: Sustained-release spansule capsules, syrup, oral solution, intramuscular injection, and the ever-so-popular suppositories (as freebase chlorpromazine).
1. Other brand names & branded generic names1
- Ampliactil (Argentina)
- Aspersinal (Argentina)
- Chlomazine (Japan)
- Chloractil (United Kingdom)
- Chlorazin (Bulgaria; Switzerland)
- Chlorpromanyl (Canada)
- Chlorpromed (Thailand)
- Clonazine (Ireland)
- Contomin (Japan)
- Duncan (Thailand)
- Esmino (Japan)
- Hibernal (Hungary; Sweden)
- Klorproman (Czech Republic; Finland)
- Klorpromazin (Finland)
- Laractyl (Philippines)
- Largactil (Australia; Bahamas; Bahrain; Barbados; Belize; Benin; Bermuda; Burkina Faso; Canada; Costa Rica; Curacao; Cyprus; Czech Republic; Denmark; Dominican Republic; Ecuador; Egypt; El Salvador; Ethiopia; Finland; France; Gambia; Ghana; Greece; Guatemala; Guinea; Guyana; Honduras; Hong Kong; Indonesia; Iraq; Italy; Ivory Coast; Jamaica; Kenya; Kuwait; Lebanon; Liberia; Libya; Lebanon; Malawi; Mali; Mauritania; Mauritius; Morocco; Dutch Antilles; Netherlands; New Zealand; Niger; Nigeria; Norway; Oman; Panama; Peru; Portugal; Qatar; Republic of Yemen; Saudi Arabia; Senegal; Seychelles; Sierra Leone; South Africa; Spain; Sudan; Surinam; Switzerland; Syria; Tanzania; Trinidad; Tunisia; Uganda; United Arab Emirates; United Kingdom; Zambia; Zimbabwe)
- Largactil Forte (New Zealand)
- Matcine (Malaysia; Thailand)
- Neomazine (Korea)
- Plegomazine (Bahamas; Barbados; Belize; Bermuda; Curacao; Guyana; Iraq; Jamaica; Dutch Antilles; Surinam; Trinidad)
- Promactil (Indonesia)
- Promexin (Japan)
- Propaphenin (Germany)
- Prozil (Denmark)
- Prozin (Italy)
- Psynor (Philippines)
- Taroctyl (Israel)
- Winsumin (Taiwan)
- Wintermin (Japan; Taiwan)
Schizophrenia, bipolar disorder (one of the first and predating lithium), intractable hiccoughs, severe nausea & vomiting (cancer chemotherapy severe), pre-surgical anxiety, tetanus, porphyria, and several conduct disorders in children. Thorazine (chlorpromazine HCl) is approved to treat both adults and children for schizophrenia and bipolar disorder.
- Migraines Mainly in emergency rooms, where it is really effective.
- Managing the pain in blind eyes.
- Steroid-induced psychosis. AKA Roid rage.
- Augmenting AIDS treatments.
It’s cheaper than dirt, it’s effective, and it treats so many seemingly unrelated things (migraines, tetanus, AIDS) that it might help you reduce the number of other meds you need to take.
You’re more likely to be hit with a movement disorder like TD or EPS than you would be if you were taking AAPs of comparable potency - which means low dosages of most everything except Risperdal and Invega, where the risk is a lot higher. Unlike other standard/typical/first-generation APs (FGAs) the chance for weight gain isn’t that much less than atypical antipsychotics (AAPs) such as Zyprexa and Seroquel.
The usual that come with any antipsychotic: weird dreams, drowsiness and lethargy, a feeling of being disconnected from reality, emotional numbing, not really giving a damn. Put it all together and they add up to what is known as, “zombification.” Fortunately most of these tend to go away, at varying rates, usually within a matter of weeks.
Because Thorazine is such a potent antihistamine weight gain is a common side effect and the lethargy/daytime drowsiness doesn’t always go away, unlike most other FGAs.
Again, the same as most APs: movement disorders, the prolactin-related side effects of enlarged tits and/or surprise lactation (for both men and women), changes in menstruation, and assorted sexual dysfunctions including priapism. Before Viagra and Cialis this guy decided to take matters into his own hands, as it were. Only because I’m batshit crazy can I understand how crushing Thorazine tablets and shoving them up your urethra to deal with erectile dysfunction could seem like a good idea. Which it’s not.
Thorazine can result in a false positive for amphetamines in a urine test. As that was from 1992 the test may no longer be used, but this is why you really do need to list all the meds you take whenever you are required to pee in a cup.
You may have had Thorazine and never knew it. Some standard antipsychotics are given in emergency rooms every day as anti-nausea medications when their chemical cousins aren’t potent enough to stop the spenching, or aren’t available for one reason or another2.
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We’re going to deal only with schizophrenia and mania, only for out-patients, and, as always, only adults. See the PI sheet for all the other situations and approved uses. Also, per the PI sheet, the dosages apply only to tablets and sustained-release Spansule capsules.
I really have to hand it to the guys at SmithKline Beecham (or whoever wrote the last PI sheet) for their honesty in admitting they have no clue as to what the dosages for the injections, oral concentrate, and suppositories really should be for long-term use:
Adjust dosage to individual and the severity of his condition, recognizing that the milligram for milligram potency relationship among all dosage forms has not been precisely established clinically. It is important to increase dosage until symptoms are controlled. Dosage should be increased more gradually in debilitated or emaciated patients. In continued therapy, gradually reduce dosage to the lowest effective maintenance level, after symptoms have been controlled for a reasonable period. —the Thorazine PI sheet
I’ve never read anything like that in a PI sheet. Their titration schedule is fairly sane:
Psychotic Disorders —Increase dosage gradually until symptoms are controlled. Maximum improvement may not be seen for weeks or even months. Continue optimum dosage [whenever the symptoms stop, usually in a range of 200–800mg a day] for 2 weeks; then gradually reduce dosage to the lowest effective maintenance level. Daily dosage of 200 mg is not unusual. Some patients require higher dosages (e.g., 800 mg daily is not uncommon in discharged mental patients).
OUTPATIENTS— Oral: 10 mg t.i.d. or q.i.d. [Three or four times a day], or 25 mg b.i.d. or t.i.d. [Two or three times a day
MORE SEVERE CASES— Oral: 25 mg t.i.d.
After 1 or 2 days, daily dosage may be increased by 20 to 50 mg at semiweekly intervals until patient becomes calm and cooperative.
PROMPT CONTROL OF SEVERE SYMPTOMS— I.M.[Intramuscular injection]: 25 mg (1 mL). If necessary, repeat in 1 hour. Subsequent doses should be oral, 25 to 50 mg t.i.d. —the Thorazine PI sheet
That “calm and cooperative” part is somewhat stereotypical. Not everyone in the lock ward, let alone outpatients, needs to be calmed down3 or forced into cooperation. Other than that the only quibble I have is a dosage increase twice a week, but only because that might be too fast for some people.
Thorazine is kind of slow for an antipsychotic. Like all antipsychotics it will do something within a day, sooner if injected, but it take up to a week before there’s a noticeable effect and, as it states in the PI sheet, it can take months before you know if Thorazine is going to fully control your symptoms or not.
I can personally attest that the effect on vomiting is nearly instant. Really. It’s TV-fast.
With most APs you can stop taking them rapidly, or immediately, in case of an emergency like a severe allergic reaction, and your ‘only’ real worry is rebound symptoms. Just as the sudden discontinuation of an antiepileptic drug can give you a seizure as a “rebound symptom” for something you don’t have, if you suddenly stop taking Thorazine (chlorpromazine) all at once you can get “rebound,” non-stop vomiting. Thorazine also has a reputation for severe rebound symptoms. Stahl recommends a 6–8 week discontinuation schedule, which is probably a bit long if you’re taking 200mg a day or less. If you’re taking 400mg a day or more, six-to-eight weeks seems about right, as you would want to reduce your dosage by 30–50mg a day every 3 to seven days.
Chlorpromazine’s half-life is anywhere from 8 to 33 hours, although it averages about four days for Thorazine to clear out of your system. Go figure.
Good question. Chlorpromazine’s pharmacokinetics are too variable to pin this down.
- Tablets: 4 years
- Sustained-release spansule capsules: ?
- Syrup: 2 years, 6 months after opening
- Oral solution: 4 years
- IM injection: 5 years
- Suppositories: ?
Based on the Communications Interference Hypothesis of psychiatric and neurological conditions (brain cooties, the crazies, etc.), Thorazine (along with all standard/typical/first-generation antipsychotics and most other APs) blocks the reception of excess dopamine at the D2 receptors to reduce the positive symptoms of schizophrenia and other psychoses, the manic side of bipolar, and similar conditions. Its antihistamine action combined with the dopamine blockade is why it works for anxiety and insomnia. The antihistamine and potent anticholinergic activity at specific receptors is what make Thorazine and other phenothiazines,4 so effective for nausea.
Your guess is as good as mine as to why Thorazine works for hiccups, tetanus, porphyria, HIV/AIDS, and even malaria.
While Prozac is probably the first med people think of when the subject of psychiatric medications comes up, when people think about the scary psych meds, Thorazine, the so-called “chemical straitjacket,” is the drug that scares the shit out of people who don’t know shit about psychiatric drugs. They need to shove a chlorpromazine suppository up their butts the next time they can’t stop puking and learn how it’s really not too bad.
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Get all critical about Thorazine
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It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on the Faecesbooks.
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If you have any questions not answered here, please see the Crazymeds Thorazine discussion board.
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Physicians’ Desk Reference Edition 53 Maria Deutsch & Anu Gupta, Drug Information Specialists, et al. © 1999. Published by Medical Economics Company.
The Prescriber’s Guide (Essential Psychopharmacology Series) Third edition by Stephen Stahl
Mosby’s 2004 Drug Guide David Nissen PharmD, Editor.© 2004. An imprint of Elsevier.
Drugs for Mental Illness: Feeling/Organism (Series of Books in Psychology) Marvin E. Lickey, Barbara Gordon. © 1983 by W. H. Freeman & Company. Published by W. H. Freeman & Company.
The New Chemotherapy in Mental Illness edited by Hirsch L. Gordon M.D., Ph.D., F.A.P.A. © 1958 Philosophical Library, Inc. Published by Philosophical Library.
1 The term "branded generic" has three meanings:
1) A generic drug produced by a generics manufacturer that is a wholly-owned subsidiary of the company that makes the branded version. E.g. Greenstone Pharmaceuticals makes gabapentin, and they are owned by Pfizer, who also own Parke-Davis, the makers of Neurontin.
2) A branded generic is also a generic drug given a 'brand' name by the manufacturer (e.g. Teva's Budeprion), but otherwise has the same active ingredient as the original branded version (Wellbutrin).
3) A branded generic is also a generic drug given a 'brand' name by the manufacturer (e.g. Sanofi-Aventis' Aplenzin, which is bupropion hydrobromide) and uses a salt of the active ingredient that is different from the original branded version and other generics (Wellbutrin, Budeprion and all the others are bupropion hydrochloride). We aren't sure if that really makes a difference or not. The FDA says they're the same thing. As usual, the data are contradictory, but most evidence indicates that the FDA is right and the differences are negligible.
For our purposes a "branded generic name" refers to the second and third definitions.
2 Such as running out of money.
3 Although when I had a timeout in a psychiatric hospital's lock ward there were a few people who badly needed to be calmed down and made to cooperate, and a B-52 (Benadryl 5mg haloperidol 2mg lorazepam) sucks less for everyone involved than strapping them to a bed with someone always sitting next to them until a relative could be contacted or court order came through; as was the case with one poor bastard who looked and sounded like star of a low-budget exorcism movie.
4 There are a whole bunch of meds classified as phenothiazines that aren't crazy meds and are used in hospitals and prescribed as anti-emetics and super antihistamines. Phenergan (promethazine HCl) is one especially effective one with as many approved and off-label uses as Thorazine. It also works on migraine-induced nausea so quickly you'll want an IV kit at home, because as soon as it's hooked up to the drip the spenching stops and you're ready to fall asleep.
5 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!
If you have any questions not answered here, please see the Crazymeds Thorazine discussion board. I welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why I write these damn things. I’m frustrated enough as it is. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds.
|Last modified on Thursday, 13 March, 2014 at 17:01:39 by JerodPoore||Page Author: Jerod Poore||Date created Wednesday, 20 July, 2011 at 17:26:10|
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Almost all of the material on this site is by Jerod Poore and is copyright © 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, and 2014 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else.
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All information on this site has been obtained through our personal experience and the experiences family, friends, what people have reported on various reputable sites all over teh intergoogles, the medications’ product information / summary of product characteristic (PI/SPC) sheets, and from sources that are referenced throughout the site. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or patient information leaflet (PIL) that comes with your medications and never ever throw them away.
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1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[begin rant] I rent a dedicated server for Crazymeds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had a forerunner of QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]