Chlorpromazine: The Drug That Changed Psychiatry
Introduced in 1952, chlorpromazine was the first widely successful antipsychotic drug and is often called the “drug that changed psychiatry.” Before its discovery, many people with schizophrenia and other psychotic disorders spent years in psychiatric hospitals. Chlorpromazine transformed mental health care by helping patients control hallucinations, delusions, and severe agitation, allowing many to return to their families and communities.
How it works:
Chlorpromazine blocks dopamine (D2) receptors in the brain, reducing psychotic symptoms and calming excessive brain activity.
Uses:
- Schizophrenia and other psychotic disorders
- Acute mania
- Severe nausea and vomiting
- Intractable hiccups
- Severe agitation
Adult dose:
- Oral: 25–50 mg, 2–3 times daily; gradually increased as needed (usual maintenance: 200–800 mg/day).
- Intramuscular (IM): 25–50 mg for acute agitation under medical supervision.
Common side effects:
Drowsiness, dry mouth, blurred vision, constipation, dizziness, low blood pressure on standing, and weight gain.
Serious side effects:
Abnormal involuntary movements (extrapyramidal symptoms), neuroleptic malignant syndrome (rare), heart rhythm changes (QT prolongation), jaundice, and agranulocytosis (rare).
Even today, chlorpromazine is remembered as a landmark medicine that revolutionized the treatment of severe mental illness and laid the foundation for modern psychiatric care.
Introduced in 1952, chlorpromazine was the first widely successful antipsychotic drug and is often called the “drug that changed psychiatry.” Before its discovery, many people with schizophrenia and other psychotic disorders spent years in psychiatric hospitals. Chlorpromazine transformed mental health care by helping patients control hallucinations, delusions, and severe agitation, allowing many to return to their families and communities.
How it works:
Chlorpromazine blocks dopamine (D2) receptors in the brain, reducing psychotic symptoms and calming excessive brain activity.
Uses:
- Schizophrenia and other psychotic disorders
- Acute mania
- Severe nausea and vomiting
- Intractable hiccups
- Severe agitation
Adult dose:
- Oral: 25–50 mg, 2–3 times daily; gradually increased as needed (usual maintenance: 200–800 mg/day).
- Intramuscular (IM): 25–50 mg for acute agitation under medical supervision.
Common side effects:
Drowsiness, dry mouth, blurred vision, constipation, dizziness, low blood pressure on standing, and weight gain.
Serious side effects:
Abnormal involuntary movements (extrapyramidal symptoms), neuroleptic malignant syndrome (rare), heart rhythm changes (QT prolongation), jaundice, and agranulocytosis (rare).
Even today, chlorpromazine is remembered as a landmark medicine that revolutionized the treatment of severe mental illness and laid the foundation for modern psychiatric care.
MBH/PS