Drug Index

Thioridazine

 
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Mechanism :

It is an antipsychotic agent with the lowest incidence of extrapyramidal side effects among phenothiazine antipsychotics. It is used in the treatment of psychosis, neurosis and behavioural problems in children.


Indication :

• Schizophrenia


Contraindications :

Hypersensitivity to phenothiazines, comatose states, pre-existing CNS depression, severe CVS disorders, uncorrected hypokalaemia or any electrolyte imbalance, known or suspected QT prolongation, history of ventricular arrhythmias including torsades de pointes and porphyria. Bone-marrow suppression, pheochromocytoma, or prolactin-dependent tumours, angle-closure glaucoma, history of jaundice, parkinsonism, DM, hypothyroidism, myasthenia gravis, paralytic ileus, prostatic hyperplasia, or urinary retention. Patients with reduced activity of cytochrome P450 isoenzyme CYP2D6.


Dosing :

2 to 12 years: Start with 0.5 mg/kg/day orally in 2 to 3 divided doses. May gradually increase up to a maximum of 3 mg/kg/day in divided doses.

13 to 18 years: Start with 50 to 100 mg orally 3 times a day. May gradually increase to 200 to 800 mg/day in 2 to 4 divided doses.

Precautions:

Due to the risk of life-threatening arrhythmias including torsades de pointes, thioridazine should be used only in patients for whom other antipsychotic drugs have not been effective or tolerable. Before initiating thioridazine, at least 2 other antipsychotics should be tried at an adequate dose and duration.


Adverse Effect :

Pseudoparkinsonism, tardive dyskinesia, dystonia, orthostatic hypotension, cholestatic jaundice, leukopenia, photosensitivity.


Interaction :

Anticholinergics: Potentiates adverse effects of anticholinergics.

TCAs: Concurrent use of TCAs leads to raised blood levels of both drugs. May antagonise effects of levodopa, bromocriptine and other dopamine agonists. Avoid co-admin with drugs that cause electrolyte imbalance.

Phenytoin: Monitor phenytoin therapy due to inconsistent effects of thioridazine on phenytoin levels.


07/21/2019 22:10:44 Thioridazine
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