Chlorpromazine: a practical guide for patients and caregivers

Chlorpromazine (often known by older brand names like Thorazine) is one of the first antipsychotic medicines. Doctors still prescribe it for psychosis, severe nausea, hiccups that won't stop, and sometimes agitation or severe anxiety when other options aren’t suitable. If you or someone you care for has been started on chlorpromazine, this page gives clear, useful info you can use right away.

How chlorpromazine works and common uses

Chlorpromazine blocks certain brain receptors, which calms hallucinations, disorganized thinking, and extreme agitation. Typical uses include treating schizophrenia, manic episodes, severe behavioral problems, and some emergency psychiatric situations. It's also used off-label for severe nausea or to help with stubborn hiccups in hospital settings. The dose and form vary — tablets, liquid, and injections exist — so follow the prescription exactly.

Side effects, interactions, and safety tips

Expect some side effects. The most common are drowsiness, dry mouth, constipation, blurred vision, and low blood pressure when standing up. More serious reactions include involuntary movements (tardive dyskinesia), muscle stiffness, fever with stiffness (neuroleptic malignant syndrome), and rhythm problems in the heart. Tell your doctor straight away if you notice muscle spasms, very high fever, irregular heartbeat, or sudden confusion.

Avoid alcohol and recreational drugs while taking chlorpromazine — they increase drowsiness and the risk of breathing problems. Many medicines interact with chlorpromazine: other sedatives, certain antidepressants, antihypertensives, and drugs that affect heart rhythm. If you start a new medicine, check with the prescriber or pharmacist about interactions. Also mention liver problems, a low blood cell count, or a personal or family history of heart rhythm issues before treatment.

Older adults can be more sensitive to side effects, especially low blood pressure and confusion. For elderly patients with dementia-related psychosis, antipsychotics including chlorpromazine have been linked with higher risk of stroke and death. Pregnant or breastfeeding people should discuss risks and benefits with their doctor; in some cases alternatives are safer.

Practical tips: take the medicine at the same time each day, avoid sudden position changes to reduce dizziness, and carry a card or note listing your meds in case of emergency. Don’t stop chlorpromazine suddenly — withdrawal can cause nausea, insomnia, and return of symptoms. If you need to stop, your doctor will lower the dose slowly.

Monitoring often includes periodic blood pressure checks, blood tests if indicated, and watching for movement side effects. If you feel unusually sleepy, have trouble breathing, faint, or develop a rash, seek medical help right away. For questions about generic vs brand, cost, or obtaining the medication safely online, talk to your pharmacist and avoid unverified sellers.

Want more details on dosing ranges, interactions with a specific drug, or how to manage side effects day-to-day? Ask your prescriber or pharmacist — they can tailor advice to your situation and health history.