If you’re wondering, “What is chlorpromazine used for?” you’ve come to the right place. As a pharmacist with years of experience in psychiatric medications, I’m here to break it down for you. Chlorpromazine—sometimes known by brand names like Thorazine or Largactil—is a first-generation antipsychotic with a surprising range of uses. Whether it’s calming psychosis or stopping hiccups, this drug has been a staple since the 1950s. Let’s explore its primary uses, how it works, and clear up any confusion with chlordiazepoxide (Librium), a completely different medication.
What Is Chlorpromazine?
Chlorpromazine belongs to the antipsychotics category, specifically the phenothiazine class. It’s available as chlorpromazine hydrochloride in tablets (e.g., chlorpromazine 25mg), syrup, or injections. In the UK, it’s detailed in the British National Formulary (BNF), guiding us pharmacists on its safe use. Unlike chlordiazepoxide (Librium), which is a benzodiazepine for anxiety, chlorpromazine tackles a broader spectrum of conditions.
Quick Fact: Chlorpromazine was the first antipsychotic, revolutionizing mental health care decades ago.
Primary Uses of Chlorpromazine
So, what is chlorpromazine used for? Here’s the rundown based on my experience and clinical guidelines:
1. Schizophrenia and Psychosis
Chlorpromazine is a go-to for treating schizophrenia and other psychotic disorders. It reduces hallucinations, delusions, and agitation by blocking dopamine D2 receptors in the brain. I’ve seen it work wonders in acute episodes, helping patients regain clarity.
- Dosage: Starts at 25–100mg daily, adjustable up to 1000mg in severe cases.
2. Bipolar Disorder (Manic Phase)
During bipolar mania, chlorpromazine stabilizes extreme mood swings and restlessness. Its sedative effects are a bonus here, calming patients in crisis.
- Why It Works: Dopamine antagonism plus sedation.
3. Chlorpromazine for Hiccups
Yes, chlorpromazine for hiccups is a real thing! It’s FDA-approved for intractable hiccups (lasting over 48 hours). By calming nerve signals to the diaphragm, it stops those relentless spasms.
- Typical Dose: 25–50mg every 6–8 hours, short-term.
4. Severe Anxiety (Short-Term)
Though not a primary choice, chlorpromazine for anxiety helps in severe, acute cases unresponsive to other treatments. Its sedation kicks in fast, offering relief.
- Caveat: It’s not for long-term anxiety—benzodiazepines like chlordiazepoxide (Librium) are better suited there.
5. Nausea and Vomiting
In palliative care or chemotherapy, chlorpromazine acts as an antiemetic, easing nausea by targeting the brain’s chemoreceptor trigger zone.
- Dose: 10–25mg every 4–6 hours as needed.
How Does Chlorpromazine Work?
Chlorpromazine’s magic lies in its mechanism of action. It blocks dopamine receptors to control psychosis, histamine receptors for sedation, and has anticholinergic and anti-serotonin effects. This multi-receptor action explains its versatility—and its side effects like drowsiness or low blood pressure.
Chlorpromazine vs. Chlordiazepoxide (Librium): Clearing the Confusion
A quick note: some folks confuse chlorpromazine with chlordiazepoxide (Librium). They’re not the same! Librium is a benzodiazepine used mainly for anxiety and alcohol withdrawal, working on GABA receptors. Chlorpromazine, an antipsychotic, targets dopamine and more. So, no, chlorpromazine is not chlordiazepoxide—different drugs, different purposes.
| Feature | Chlorpromazine | Chlordiazepoxide (Librium) |
|---|---|---|
| Category | Antipsychotic | Benzodiazepine |
| Main Uses | Psychosis, hiccups, nausea | Anxiety, alcohol withdrawal |
| Mechanism | Dopamine blockade | GABA enhancement |
| Sedation | High | Moderate |
Side Effects to Know
Chlorpromazine’s benefits come with risks:
- Common: Drowsiness, dry mouth, constipation.
- Serious: Extrapyramidal symptoms (EPS), low blood pressure, tardive dyskinesia.
We pharmacists always recommend monitoring and reporting unusual symptoms to your doctor.
Why Chlorpromazine Still Matters
Despite newer antipsychotics, chlorpromazine’s affordability and efficacy keep it in use. From chlorpromazine 25mg tablets to injections, it’s a versatile option listed in the BNF chlorpromazine guidelines.
Final Thoughts
So, what is chlorpromazine used for? It’s an antipsychotic powerhouse for schizophrenia, bipolar mania, hiccups, nausea, and even severe anxiety in a pinch. Not to be confused with chlordiazepoxide (Librium), it’s a unique tool in our pharmacy arsenal. Have questions? Drop them below—I’d love to help!