Pericyazine is presumed to act primarily in the subcortical areas, by blocking central alpha-adrenergic receptors and the D1 dopamine receptor.
The presumed effectiveness of antipsychotic drugs relied on their ability to block dopamine receptors. This assumption arose from the dopamine hypothesis that maintains that both schizophrenia and bipolar disorder are a result of excessive dopamine activity.
Dosage
Indication
Dose
Schizophrenia and other psychoses
By mouth
ADULT:
Initially 75 mg daily in divided doses,
Increased at weekly intervals by 25 mg, according to response.
Maximum 300 mg per day.
ELDERLY or debilitated patients:
Initially 15-30 mg daily in divided doses, then
Increased at weekly intervals by 25 mg, according to response.
Maximum 300 mg per day
Short-term adjunctive management of severe anxiety,
and violent or dangerously impulse behaviour
By mouth
ADULT:
15-30 mg daily in 2 divided doses
ELDERLY or debilitated patients:
5-10 mg 2-3 daily in 2 divided doses
Side Effects
Most serious and/or frequently occurring adverse effects of periciazine include the following:
Possible side effects include:
Behavioral:
Drowsiness is common at the start of treatment, but this effect usually eases off within a few days.
Impaired psychomotor activity is a frequent side-effect.
Hepatic:
Jaundice occurs in a very small percentage of patients. Treatment should be withheld on the development of jaundice
Cardiovascular:
Postural hypotension commonly occurs, especially in the elderly.
Haematological:
Agranulocytosis may occur rarely.
The occurrence of unexplained infections or fever requires immediate haematological investigation.
Nervous system:
Extrapyramidal effects include:
Acute dystonia, akathisia
Parkinsonism shown as tremor, rigidity, akinesia, is more common in the elderly
Tardive Dyskinesia
It may appear in patients on long term therapy.
The risk appears to be greater in elderly patients on high dose therapy, especially females.
It is characterized by rhythmical involuntary movement of tongue, face, mouth, or jaw (e.g. protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements).
Neuroleptic Malignant Syndrome:
A potentially fatal syndrome.
It is characterized by muscular rigidity, fever, hyperthermia, and autonomic instability (e.g. tachycardia, labile blood pressure, profuse sweating, dyspnoea)
Skin:
Owing to contact skin hypersensitivity should avoid direct contact with the drug,
Because of the risk of photosensitization, patients should be advised to avoid exposure to direct sunlight and that retinal changes may occur.
