trifluoperazine

General information

• Class: Antipsychotic
• Common US brands: Stelazine
• Typical dose range: Anxiety (non-psychotic): label describes a usual dosage of 1–2 mg twice daily and states not to exceed 6 mg/day or use longer than 12 weeks (label).
• Therapeutic drug monitoring not routinely recommended.
• Last reviewed: 2026-02-22

Dosing & forms

• Forms/strengths: Tablets: 1 mg, 2 mg, 5 mg, 10 mg (label/manufacturer-dependent).
• Frequency: Anxiety (non-psychotic): label describes a usual dosage of 1–2 mg twice daily and states not to exceed 6 mg/day or use longer than 12 weeks (label).
• Typical range: Anxiety (non-psychotic): label describes a usual dosage of 1–2 mg twice daily and states not to exceed 6 mg/day or use longer than 12 weeks (label).

Mechanism (brief)

High-potency phenothiazine first-generation antipsychotic (D2 antagonism). Has a label indication for short-term treatment of non-psychotic anxiety, but carries antipsychotic-class risks including tardive dyskinesia.

Metabolism & Half‑life

• Metabolism: Hepatic metabolism
• Half‑life: —

Therapeutic Drug Monitoring (TDM)

Recommended: No

Monitoring highlights

• Movement symptoms (akathisia, rigidity, tremor; tardive dyskinesia screening).
• Sedation and orthostatic symptoms (falls risk).
• Hyperprolactinemia symptoms (amenorrhea, galactorrhea, sexual dysfunction).
• Duration limits when used for non-psychotic anxiety (≤12 weeks per label).
• Reassess anxiety benefit early and document a stop plan (label/clinical).

Sources

• Trifluoperazine 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)