chlorpromazine

Antipsychotic

Brands: Thorazine

Last reviewed 2025-12-30

Reviewed by PsychMed Editorial Team.

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Quick answers

What is chlorpromazine?
Chlorpromazine (brand Thorazine) is a low-potency FGA (phenothiazine) used for schizophrenia and other psychotic disorders. It is also labeled for several non-psychiatric indications such as nausea/vomiting and intractable hiccups (label-dependent).
What is Thorazine?
Thorazine is a brand name for chlorpromazine.
What is Thorazine (chlorpromazine) used for?
Label indications include: Schizophrenia and other psychotic disorders; acute mania; nausea/vomiting; intractable hiccups (label-dependent).
What drug class is Thorazine (chlorpromazine)?
Antipsychotic.
What is the mechanism of action of Thorazine (chlorpromazine)?
Low-potency phenothiazine first-generation antipsychotic (D2 antagonism) with prominent antihistamine (H1) and anticholinergic effects; often associated with sedation and orthostatic hypotension.
What strengths does Thorazine (chlorpromazine) come in?
Oral tablets: 10 mg, 25 mg, 50 mg, 100 mg, 200 mg (manufacturer-dependent); label notes higher strengths for severe neuropsychiatric conditions.
Is Thorazine (chlorpromazine) a controlled substance?
No — it is not scheduled as a controlled substance under U.S. federal law.

Snapshot

Class: Antipsychotic
Common US brands: Thorazine
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2025-12-30

Label indications

Schizophrenia and other psychotic disorders; acute mania; nausea/vomiting; intractable hiccups (label-dependent).

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Clinical Highlights

Chlorpromazine (brand Thorazine) is a low-potency FGA (phenothiazine) used for schizophrenia and other psychotic disorders. It is also labeled for several non-psychiatric indications such as nausea/vomiting and intractable hiccups (label-dependent). Compared with high-potency FGAs (e.g., haloperidol), chlorpromazine tends to cause less EPS at equivalent antipsychotic effect, but it more often causes sedation, orthostatic hypotension, and anticholinergic side effects (dry mouth, constipation, urinary retention) because of H1/α1/muscarinic activity (label/clinical).

Many modern schizophrenia regimens start with an SGA because of tolerability and broader evidence bases. Chlorpromazine can still be a pragmatic option when cost, prior response, or sedation goals shape the plan, but side-effect burden frequently limits long-term use (AHRQ/clinical).
Like all antipsychotics, chlorpromazine carries the class boxed warning for increased mortality in elderly patients with dementia-related psychosis (label).
The compare view, chlorpromazine evidence feed, and chlorpromazine print page help teams weigh sedation/orthostasis against movement and metabolic trade-offs.

Dosing & Formulations

Oral tablets include 10 mg, 25 mg, 50 mg, 100 mg, and 200 mg strengths (label/manufacturer-dependent). The label notes that 100 mg and 200 mg tablets are for severe neuropsychiatric conditions. Psychotic disorders dosing is individualized and typically titrated gradually. Label examples include outpatient starts such as 10 mg three or four times daily or 25 mg two or three times daily, with higher doses used as needed based on setting and symptom severity (label).

For less acutely disturbed hospitalized patients, the label describes 25 mg three times daily titrated up to an effective dose (often ~400 mg daily), while acute schizophrenic or manic states may require higher daily doses (label).
For acute schizophrenia or mania, the label notes 500 mg/day is generally sufficient, and while gradual increases up to 2,000 mg/day may be necessary, it suggests little gain from exceeding 1,000 mg/day for extended periods (label).
Non-psychiatric label examples include nausea/vomiting dosing of 10–25 mg every 4–6 hours as needed and intractable hiccups dosing of 25–50 mg three or four times daily (label).

Monitoring & Risks

Sedation and orthostatic hypotension are common functional-limiting effects; falls risk is a practical monitoring priority, especially in older adults or polypharmacy (label/clinical). Anticholinergic effects (constipation, urinary retention, blurred vision, delirium risk) can be clinically significant, particularly in medically ill or older patients (label/clinical).

Movement-disorder risk remains: parkinsonism, akathisia, dystonia, and tardive dyskinesia can occur with FGAs and warrants periodic screening (label/clinical).
Rare but important antipsychotic risks include neuroleptic malignant syndrome and clinically significant hypotension; urgent reassessment is typical when these are suspected (label).
Metabolic monitoring is still reasonable because weight gain and appetite changes can occur with low-potency phenothiazines (AHRQ/clinical).

Drug Interactions

Additive CNS depression can occur with alcohol, opioids, benzodiazepines, sedating antihistamines, and other sedative psychotropics; total sedative load is often the practical risk driver (clinical). Additive anticholinergic burden with tricyclic antidepressants, bladder antimuscarinics, and other anticholinergic agents can increase delirium and urinary retention risk (clinical).

QT-prolonging combinations and electrolyte abnormalities can increase arrhythmia risk; ECG-based monitoring is commonly considered when multiple risk factors exist (clinical).
Because dosing is individualized and spans multiple indications, teams often reassess interacting meds when chlorpromazine is used for non-psychiatric reasons (e.g., antiemetic use) in complex inpatients (clinical).

Practice Notes

In schizophrenia care, chlorpromazine is often discussed in the context of balancing sedation/orthostasis against EPS and metabolic effects; compare views can support shared language across the care team. If chlorpromazine is used for nausea/vomiting or hiccups in patients on other psychotropics, the plan often includes a short horizon and a stop/reassess checkpoint to avoid “stacked” sedatives (clinical).

For relapse prevention where adherence is uncertain, LAI options are usually evaluated early because chlorpromazine has no depot formulation (APA/clinical).

References

Chlorpromazine hydrochloride tablets prescribing information — DailyMed (2025)
First Generation Versus Second Generation Antipsychotics IN Adults: Comparative Effectiveness — Agency for Healthcare Research and Quality (NCBI Bookshelf) (2012)
The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia — American Psychiatric Association (2020)
AGNP Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology — Pharmacopsychiatry (2018)