TL;DR
- Thorazine (chlorpromazine) is a first‑generation antipsychotic used mainly for schizophrenia, severe nausea, and mania.
- Typical adult dose starts at 25‑50mg daily, titrated up to 800mg depending on response.
- Common side effects include drowsiness, dry mouth, weight gain, and movement disorders like tardive dyskinesia.
- Blood work and heart monitoring are essential during long‑term therapy.
- Never stop abruptly; taper under medical supervision to avoid withdrawal.
What Is Thorazine and When Is It Prescribed?
Thorazine, whose generic name is chlorpromazine, belongs to the phenothiazine class of drugs. It was the first antipsychotic approved in the 1950s and paved the way for modern psychiatric treatment. Today, doctors reserve it for cases where newer atypical antipsychotics either fail or cause intolerable side effects.
Typical indications include:
- Schizophrenia and other psychotic disorders.
- Manic episodes in bipolar disorder when mood stabilisers aren’t enough.
- Severe nausea and vomiting that don’t respond to standard anti‑emetics.
- Acute psychosis in hospital settings, especially when rapid calming is needed.
In Australia, Thorazine is listed on the Pharmaceutical Benefits Scheme (PBS) for specific psychiatric conditions, but a specialist’s prescription is required.
How to Use Thorazine: Dosage, Administration, and Monitoring
Dosage varies widely based on the condition, patient age, and how they metabolise the drug. Below is a quick reference for adults; paediatric dosing should only be handled by a child‑psychiatrist.
| Indication | Starting Dose | Typical Maintenance Range | Maximum Daily Dose |
|---|---|---|---|
| Schizophrenia | 25‑50mg PO daily | 200‑600mg PO daily | 800mg PO |
| Acute Mania | 100mg PO or IM | 300‑600mg PO daily | 800mg PO |
| Severe Nausea | 10‑25mg IV/IM | Up to 100mg per day | 100mg per day |
Key administration tips:
- Take the tablet with food to lessen stomach upset.
- If you’re on the injectable form, a healthcare professional will rotate the injection site.
- Never split extended‑release tablets; they’re designed to release the drug slowly.
- Stay consistent with timing - it helps maintain stable blood levels.
Monitoring is crucial. Doctors usually order:
- Baseline and quarterly complete blood counts (CBC) - phenothiazines can affect white cells.
- Electrocardiograms (ECG) if you have heart disease, because Thorazine can prolong the QT interval.
- Weight and fasting glucose every 3‑6 months - metabolic side effects are common.
If you miss a dose, take it as soon as you remember unless it’s almost time for the next one. In that case, skip the missed tablet and resume your regular schedule. Do not double‑dose.
Side Effects, Risks, and How to Manage Them
Every medication carries trade‑offs. Understanding what to expect empowers you to act early and keep side effects under control.
| Side Effect | Frequency | Management Tips |
|---|---|---|
| Drowsiness | Common (≈30%) | Take at night; avoid driving until you know how it affects you. |
| Dry mouth | Common | Chew sugar‑free gum, sip water, consider saliva substitutes. |
| Weight gain | Moderate | Track calories, integrate light exercise, discuss metformin with your doctor. |
| Extrapyramidal symptoms (EPS) | Less common | Report tremors or rigidity; an anticholinergic like benztropine may be added. |
| Tardive dyskinesia | Rare but serious | Regular movement exams; if symptoms appear, discuss switching to an atypical antipsychotic. |
| QT prolongation | Rare | Avoid other QT‑prolonging drugs; get periodic ECGs. |
Other concerns include:
- Photosensitivity: Sunburns happen quicker; wear sunscreen and protective clothing.
- Orthostatic hypotension: Rise slowly from sitting; stay hydrated.
- Potential drug interactions: Don’t mix with MAO inhibitors, some antidepressants, or alcohol without checking with your prescriber.
If you experience severe muscle stiffness, fever, or confusion, seek medical help immediately - these could signal neuroleptic malignant syndrome, a medical emergency.
Practical Tips, FAQs, and Next Steps
Below are the most common questions people ask after starting Thorazine.
Can I drink alcohol while on Thorazine?
Alcohol amplifies drowsiness and can worsen blood pressure drops. Occasional light drinking is usually okay, but discuss any amount with your doctor.
How long do I need to stay on the medication?
Long‑term therapy is typical for chronic psychosis, but some patients taper off after a stable period of 1‑2years. Never discontinue on your own.
Is Thorazine safe during pregnancy?
Animal studies suggest risks, and human data are limited. It’s classified as Category C in Australia - only use if benefits outweigh potential harms, under specialist guidance.
What should I do if I forget a dose?
Take it as soon as you remember unless the next dose is due within a few hours. In that case, skip the missed one.
Are there natural alternatives for nausea?
Ginger, acupressure, and certain antihistamines can help mild cases. For severe, medication‑induced vomiting, Thorazine remains the most effective option.
**Next steps**: Talk to your GP or psychiatrist about whether Thorazine fits your treatment plan. Ask for a baseline ECG and blood work before you start. Keep a side‑effect diary - it makes follow‑up appointments more productive.
If you’re already on Thorazine, schedule a medication review every six months. Adjustments are common, and staying proactive helps you avoid surprises.
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