First-generation (typical) antipsychotic; phenothiazine derivative
Dopamine D2 receptor antagonist; also blocks histamine, cholinergic, and alpha-adrenergic receptors
Schizophrenia, psychotic disorders, severe behavioral problems in children, nausea/vomiting, intractable hiccups
Agitation and aggression in neurodevelopmental disabilities (higher adverse risk)
Oral tablets, intramuscular injection, suppository
25–50 mg p.o. BID, titrated gradually
100–800 mg/day
Hepatic metabolism; half-life ~30 hours
Sedation, orthostatic hypotension, anticholinergic effects, weight gain
Tardive dyskinesia, neuroleptic malignant syndrome, cholestatic jaundice, prolonged QT interval
Monitor for EPS (e.g., AIMS every 6–12 months), weight and metabolic parameters periodically, and ECG if cardiac risk factors or polypharmacy. Consider prolactin or liver enzymes if symptomatic.
Increased mortality in elderly patients with dementia-related psychosis
Chlorpromazine carries higher risk of sedation, hypotension, and EPS in neurodevelopmental disabilities; reserve for severe cases when other agents fail. Use with caution in elderly and those with cardiovascular disease.