Movatterモバイル変換

[0]ホーム
URL:

Jump to content
WikipediaThe Free Encyclopedia
Search

Trifluoperazine

From Wikipedia, the free encyclopedia
Typical antipsychotic medication
Pharmaceutical compound
Trifluoperazine
Clinical data
Trade namesStelazine, Eskazinyl, Eskazine, Jatroneural, others
AHFS/Drugs.comMonograph
MedlinePlusa682121
Pregnancy
category
Routes of
administration		By mouth,IM
Drug classTypical antipsychotic
ATC code
Legal status
Legal status
Pharmacokinetic data
MetabolismLiver
Eliminationhalf-life10–20 hours
Identifiers
  • 10-[3-(4-methylpiperazin-1-yl)propyl]-
    2-(trifluoromethyl)-10H-phenothiazine
CAS Number
PubChemCID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
ChEBI
ChEMBL
PDB ligand
CompTox Dashboard(EPA)
ECHA InfoCard100.003.837Edit this at Wikidata
Chemical and physical data
FormulaC21H24F3N3S
Molar mass407.50 g·mol−1
3D model (JSmol)
  • FC(F)(F)c2cc1N(c3c(Sc1cc2)cccc3)CCCN4CCN(C)CC4
  • InChI=1S/C21H24F3N3S/c1-25-11-13-26(14-12-25)9-4-10-27-17-5-2-3-6-19(17)28-20-8-7-16(15-18(20)27)21(22,23)24/h2-3,5-8,15H,4,9-14H2,1H3 checkY
  • Key:ZEWQUBUPAILYHI-UHFFFAOYSA-N checkY
  (verify)

Trifluoperazine, marketed under the brand nameStelazine among others, is atypical antipsychotic primarily used to treatschizophrenia.[2] It may also be used short term in those withgeneralized anxiety disorder but is less preferred tobenzodiazepines.[2] It is of thephenothiazinechemical class. It was approved for medical use in the United States in 1959.[3]

Medical uses

[edit]

Schizophrenia

[edit]

Trifluoperazine is an effectiveantipsychotic for people with schizophrenia condition.[4] There is low-quality evidence that trifluoperazine increases the chance of being improved when compared to placebo when people are followed up for 19 weeks.[4] There is low-quality evidence that trifluoperazine reduces the risk of relapse when compared with placebo when people are followed for 5 months.[4] As of 2014 there was no good evidence for a difference between trifluoperazine andplacebo with respect to the risk of experiencing intensified symptoms over a 16-week period nor in reducing significant agitation or distress.[4]

There is no good evidence that trifluoperazine is more effective for schizophrenia than lower-potency antipsychotics likechlorpromazine,chlorprothixene,thioridazine andlevomepromazine, but trifluoperazine appears to cause more adverse effects than these drugs.[5]

Other

[edit]

It appears to be effective for people withgeneralized anxiety disorder but the benefit–risk ratio was unclear as of 2005.[6]

It has been experimentally used as a drug to killeukaryoticpathogens such asBalamuthia in humans.[7]

Side effects

[edit]

Its use in many parts of the world has declined because of highly frequent and severe early and latetardive dyskinesia, a type ofextrapyramidal symptom. The annual development rate of tardive dyskinesia may be as high as 4%.[citation needed]

A 2004meta-analysis of the studies on trifluoperazine found that it is more likely than placebo to cause extrapyramidal side effects such asakathisia,dystonia, andParkinsonism.[8] It is also more likely to causesomnolence and anticholinergic side effects such asred eye andxerostomia (dry mouth).[8] All antipsychotics can cause the rare and sometimes fatalneuroleptic malignant syndrome.[9] Trifluoperazine can lower the seizure threshold.[10] Theantimuscarinic action of trifluoperazine can cause excessive dilation of the pupils (mydriasis), which increases the chances of patients withhyperopia developingglaucoma.[11]

Contraindications

[edit]

Trifluoperazine is contraindicated inCNS depression,coma, andblood dyscrasias. Trifluoperazine should be used with caution in patients suffering from renal or hepatic impairment.

Mechanism of action

[edit]

Trifluoperazine has centralantiadrenergic,[12]antidopaminergic,[13][14] and minimalanticholinergic effects.[15] It is believed to work by blockading dopamineD1 andD2 receptors in themesocortical andmesolimbic pathways, relieving or minimizing such symptoms of schizophrenia ashallucinations,delusions, and disorganized thought and speech.[8] It also has antihistaminergic properties (H1Ki = 17.5[16]).Like otherphenothiazine derivatives, it also inhibitstubulin polymerization.[17]

Names

[edit]

Brand names include Eskazinyl, Eskazine, Jatroneural, Modalina, Sizonil, Stelazine, Stilizan, Terfluzine, Trifluoperaz and Triftazin.

In theUnited Kingdom and some other countries, trifluoperazine is sold and marketed under the brand 'Stelazine'.

The drug is sold as tablet, liquid and 'Trifluoperazine-injectable USP' for deepintramuscular short-term use.

In the past, trifluoperazine was used in fixed combinations with theMAO inhibitor (antidepressant)tranylcypromine (tranylcypromine/trifluoperazine) to attenuate the strong stimulating effects of this antidepressant. This combination was sold under the brand name Jatrosom N, Stelapar, Parstelin, among others. It remained available inItaly under the brand name Parmodalin (10 mg of tranylcypromine and 1 mg of trifluoperazine) until its discontinuation in 2019.

Likewise, a combination withamobarbital (potent sedative/hypnotic agent) for the amelioration ofpsychoneurosis andinsomnia existed under the brand name Jalonac.

References

[edit]
  1. ^Anvisa (2023-03-31)."RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial" [Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control] (in Brazilian Portuguese).Diário Oficial da União (published 2023-04-04).Archived from the original on 2023-08-03. Retrieved2023-08-16.
  2. ^ab"Trifluoperazine Hydrochloride". The American Society of Health-System Pharmacists. Retrieved8 January 2017.
  3. ^Howland RH (January 2016). "Trifluoperazine: A Sprightly Old Drug".Journal of Psychosocial Nursing and Mental Health Services.54 (1):20–2.doi:10.3928/02793695-20151223-01.PMID 26760133.
  4. ^abcdKoch K, Mansi K, Haynes E, Adams CE, Sampson S, Furtado VA (January 2014)."Trifluoperazine versus placebo for schizophrenia".The Cochrane Database of Systematic Reviews.1 (1) CD010226.doi:10.1002/14651858.CD010226.pub2.PMC 6718209.PMID 24414883.Wikiversity:Trifluoperazine versus placebo for schizophrenia § References
  5. ^Tardy M, Dold M, Engel RR, Leucht S (July 2014)."Trifluoperazine versus low-potency first-generation antipsychotic drugs for schizophrenia".The Cochrane Database of Systematic Reviews (7) CD009396.doi:10.1002/14651858.CD009396.pub2.PMC 11227318.PMID 25003310.
  6. ^Baldwin DS, Polkinghorn C (June 2005)."Evidence-based pharmacotherapy of Generalized Anxiety Disorder".The International Journal of Neuropsychopharmacology.8 (2):293–302.doi:10.1017/S1461145704004870.PMID 15576000.
  7. ^Deetz TR, Sawyer MH, Billman G, Schuster FL, Visvesvara GS (November 2003)."Successful treatment of Balamuthia amoebic encephalitis: presentation of 2 cases".Clinical Infectious Diseases.37 (10):1304–1312.doi:10.1086/379020.PMID 14583863.
  8. ^abcMarques LO, Lima MS, Soares BG (2004)."Trifluoperazine for schizophrenia".Cochrane Database of Systematic Reviews.2004 (1) CD003545.doi:10.1002/14651858.CD003545.pub2.PMC 7003674.PMID 14974020.
  9. ^Smego RA, Durack DT (June 1982). "The neuroleptic malignant syndrome".Archives of Internal Medicine.142 (6):1183–5.doi:10.1001/archinte.142.6.1183.PMID 6124221.
  10. ^Hedges D, Jeppson K, Whitehead P (July 2003). "Antipsychotic medication and seizures: a review".Drugs of Today.39 (7):551–7.doi:10.1358/dot.2003.39.7.799445.PMID 12973403.
  11. ^Boet DJ (July 1970). "Toxic effects of phenothiazines on the eye".Documenta Ophthalmologica. Advances in Ophthalmology.28 (1):1–69.doi:10.1007/BF00153873.hdl:1765/26543.PMID 5312274.S2CID 26145461.
  12. ^Huerta-Bahena J, Villalobos-Molina R, García-Sáinz JA (January 1983)."Trifluoperazine and chlorpromazine antagonize alpha 1- but not alpha2- adrenergic effects".Molecular Pharmacology.23 (1):67–70.doi:10.1016/S0026-895X(25)14231-4.PMID 6135146. Retrieved2009-06-21.
  13. ^Seeman P, Lee T, Chau-Wong M, Wong K (June 1976). "Antipsychotic drug doses and neuroleptic/dopamine receptors".Nature.261 (5562):717–9.Bibcode:1976Natur.261..717S.doi:10.1038/261717a0.PMID 945467.S2CID 4164538.
  14. ^Creese I, Burt DR, Snyder SH (1996)."Dopamine receptor binding predicts clinical and pharmacological potencies of antischizophrenic drugs".The Journal of Neuropsychiatry and Clinical Neurosciences.8 (2):223–6.doi:10.1176/jnp.8.2.223.PMID 9081563. Archived fromthe original on 2011-07-27. Retrieved2009-06-21.
  15. ^Ebadi MS (1998)."Trifluoperazine Hydrochloride".CRC desk reference of clinical pharmacology (illustrated ed.). CRC Press.ISBN 978-0-8493-9683-0. Retrieved2009-06-21.
  16. ^Hill SJ, Young M (December 1978). "Antagonism of central histamine H1 receptors by antipsychotic drugs".European Journal of Pharmacology.52 (3–4):397–399.doi:10.1016/0014-2999(78)90297-2.PMID 32056.
  17. ^Baksheeva VE, La Rocca R, Allegro D, Derviaux C, Pasquier E, Roche P, Morelli X, Devred F, Golovin AV, Tsvetkov PO (2025)."NanoDSF Screening for Anti-tubulin Agents Uncovers New Structure–Activity Insights".Journal of Medicinal Chemistry.68 (16):17485–17498.doi:10.1021/acs.jmedchem.5c01008.PMC 12406199.PMID 40815226.
Typical
Disputed
Atypical
Others
α1
Agonists
Antagonists
α2
Agonists
Antagonists
β
Agonists
Antagonists
D1-like
Agonists
PAMs
Antagonists
D2-like
Agonists
Antagonists
H1
Agonists
Antagonists
H2
Agonists
Antagonists
H3
Agonists
Antagonists
H4
Agonists
Antagonists
5-HT1
5-HT1A
5-HT1B
5-HT1D
5-HT1E
5-HT1F
5-HT2
5-HT2A
5-HT2B
5-HT2C
5-HT3–7
5-HT3
5-HT4
5-HT5A
5-HT6
5-HT7
σ1
σ2
Unsorted
Classes
Antidepressants
(Tricyclic antidepressants(TCAs))
Antihistamines
Antipsychotics
Anticonvulsants
Anticholinergics
Others
Retrieved from "https://en.wikipedia.org/w/index.php?title=Trifluoperazine&oldid=1320189079"
Categories:
Hidden categories:
[8]ページ先頭
©2009-2025 Movatter.jp