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Chlorpromazine: What It Treats and How to Use It Safely

Chlorpromazine is an older antipsychotic drug used for schizophrenia, severe agitation, bipolar mania, and some nausea or hiccups that won’t stop. Doctors may also use it short-term for severe anxiety in emergency settings. It’s not the newest medication, but it still works for many people when chosen carefully.

How chlorpromazine works and common uses

Chlorpromazine blocks several brain receptors, especially dopamine, which reduces symptoms like hallucinations, delusions, and extreme agitation. It can calm a person quickly when they’re highly agitated or psychotic. Typical uses include treating acute psychosis, controlling manic episodes, sedating patients in emergencies, and sometimes easing stubborn nausea.

Dosing varies a lot. For acute agitation, doctors may give a higher dose once or in divided doses. For long-term control of psychosis, smaller daily doses spread out are common. Always follow the doctor’s prescription — do not change the dose or stop suddenly without medical advice.

Side effects, interactions, and safety tips

Chlorpromazine can cause drowsiness, weight gain, dry mouth, constipation, low blood pressure when standing, and blurred vision. Some people develop movement problems called extrapyramidal symptoms — tremors, stiffness, or restlessness. Long-term use can lead to tardive dyskinesia, an often permanent involuntary movement disorder. Older adults and people with heart, liver, or severe lung disease need extra caution.

Avoid alcohol and other sedatives while taking chlorpromazine — they increase drowsiness and breathing problems. It can interact with many medicines: some blood pressure drugs, some antidepressants, and other antipsychotics. Tell your doctor about all prescription drugs, OTC meds, and supplements you take.

Simple tips that help: take it at the same times each day, stand up slowly to avoid dizziness, chew sugarless gum or drink water for dry mouth, and keep a daily record of symptoms and side effects to share with your prescriber. If you start new involuntary movements, muscle stiffness, fever, severe confusion, or very low heart rate, seek medical care right away.

Pregnant or breastfeeding people should discuss risks and benefits with their doctor — chlorpromazine can affect the newborn and may require special monitoring. If you have a history of seizures, liver disease, or low white blood cell counts, your doctor will weigh options carefully and may order blood tests while you’re on the drug.

Chlorpromazine is effective for many and lifesaving in some emergencies. But it needs careful monitoring because of its side effects and drug interactions. Ask your clinician about alternatives, what to expect early in treatment, and a clear follow-up plan so you can use it as safely as possible.

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