Trakimazin (Trifluoperazine hydrochloride)

Drug Class: Phenothiazine antipsychotic (typical antipsychotic)

Mechanism of Action: Trifluoperazine blocks postsynaptic dopamine D1 and D2 receptors in the mesolimbic and mesocortical pathways of the central nervous system. This dopamine antagonism is responsible for its antipsychotic effects.

Indications:

• Schizophrenia and other psychotic disorders

• Short-term treatment of generalized anxiety disorder (resistant to other treatments)

• Non-psychotic anxiety (short-term, off-label in some countries)

Dosage Forms: Tablets: 1 mg, 2 mg, 5 mg

Typical Dosage (adults):

• Schizophrenia: 2-5 mg twice daily, gradually increased up to 15-20 mg daily

• Anxiety: 1-2 mg twice daily, maximum 6 mg daily

Contraindications:

• Hypersensitivity to phenothiazines

• Coma or severe CNS depression

• Bone marrow suppression

• Pheochromocytoma

• Concomitant use with large doses of CNS depressants

Common Side Effects:

• Extrapyramidal symptoms (tremor, rigidity, akathisia, dystonia)

• Drowsiness, dizziness

• Dry mouth, blurred vision

• Constipation, urinary retention

• Tardive dyskinesia (with long-term use)

Serious Warnings:

• Neuroleptic Malignant Syndrome (NMS) – medical emergency

• Tardive dyskinesia – potentially irreversible

• Prolonged QT interval

• Seizure threshold reduction

• Agranulocytosis (rare but serious)

Pregnancy: Category C – use only if benefit outweighs risk

Breastfeeding: Not recommended – excreted in human milk

Interactions:

• CNS depressants (alcohol, benzodiazepines, opioids) – increased sedation

• Anticholinergic drugs – increased anticholinergic effects

• Lithium – increased risk of extrapyramidal symptoms

• Levodopa – antagonized effects

Storage: Store below 25°C, protect from light, keep out of reach of children

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Drug Class: Phenothiazine antipsychotic (typical antipsychotic)

Mechanism of Action: Trifluoperazine blocks postsynaptic dopamine D1 and D2 receptors in the mesolimbic and mesocortical pathways of the central nervous system. This dopamine antagonism is responsible for its antipsychotic effects.

Indications:

• Schizophrenia and other psychotic disorders

• Short-term treatment of generalized anxiety disorder (resistant to other treatments)

• Non-psychotic anxiety (short-term, off-label in some countries)

Dosage Forms: Tablets: 1 mg, 2 mg, 5 mg

Typical Dosage (adults):

• Schizophrenia: 2-5 mg twice daily, gradually increased up to 15-20 mg daily

• Anxiety: 1-2 mg twice daily, maximum 6 mg daily

Contraindications:

• Hypersensitivity to phenothiazines

• Coma or severe CNS depression

• Bone marrow suppression

• Pheochromocytoma

• Concomitant use with large doses of CNS depressants

Common Side Effects:

• Extrapyramidal symptoms (tremor, rigidity, akathisia, dystonia)

• Drowsiness, dizziness

• Dry mouth, blurred vision

• Constipation, urinary retention

• Tardive dyskinesia (with long-term use)

Serious Warnings:

• Neuroleptic Malignant Syndrome (NMS) – medical emergency

• Tardive dyskinesia – potentially irreversible

• Prolonged QT interval

• Seizure threshold reduction

• Agranulocytosis (rare but serious)

Pregnancy: Category C – use only if benefit outweighs risk

Breastfeeding: Not recommended – excreted in human milk

Interactions:

• CNS depressants (alcohol, benzodiazepines, opioids) – increased sedation

• Anticholinergic drugs – increased anticholinergic effects

• Lithium – increased risk of extrapyramidal symptoms

• Levodopa – antagonized effects

Storage: Store below 25°C, protect from light, keep out of reach of children