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First-generation antipsychotic (piperazine phenothiazine)

Trifluoperazine

Brand names: Stelazine

Trifluoperazine is a piperazine phenothiazine first-generation antipsychotic used in schizophrenia and other psychoses, and at lower doses for short-term severe anxiety.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It is a potent central dopamine D2 receptor antagonist; compared with low-potency phenothiazines it has stronger antipsychotic potency and a higher propensity for extrapyramidal effects but less sedation.

Prescribing in practice

  • It has a high propensity to cause extrapyramidal symptoms, including acute dystonia, parkinsonism and tardive dyskinesia.
  • Class risks include QT-interval prolongation and neuroleptic malignant syndrome.
  • Caution is required in cardiovascular disease, epilepsy, hepatic impairment and in the elderly.

Monitoring

Monitor closely for extrapyramidal symptoms and tardive dyskinesia, along with metabolic parameters and ECG where indicated.

Counselling the patient

  • Report any abnormal movements, muscle stiffness, restlessness or tremor to your doctor.
  • Seek urgent help if you develop a high fever with muscle rigidity and confusion.
  • Do not stop the medicine suddenly without medical advice.

Evidence & guidelines

Use of trifluoperazine is supported by long-standing clinical experience and NICE guidance on antipsychotic treatment of psychosis and schizophrenia.

Reference: NICE CG178; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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