Talk:Chlorpromazine

Lunatic asylums

I don't think the term "Lunatic Asylums" is an appropriate term for psychiatric hospitals. It is not a factual term, but rather a derogatory one. It is not a neutral term either, as it has very negative connotations.

I agree and changed the wording to psychiatric hospitals. Cheers, PaddyM 19:25, 12 February 2007 (UTC)

What worries me is that someone editing wikipedia pages though that Lunatic Asylums was a appropriate term. Give him/her some thorazine. Annoying username (talk) 11:38, 16 June 2008 (UTC)

Uses

"Common uses" text just seems to be a lot of opinion.

The extensive use of single in double quotes in the first paragraph under "Common uses" did not improve my confidence in the information I was trying to look up. Is this necessary, or all of these sneer quotes? 66.92.73.217 07:27, 10 March 2007 (UTC)

It does seem to be a lot of NPOV or weasel words - I'm tempted to flag it as such. Alex 08:05, 3 April 2007 (UTC)

Promazine HCl vs. Chlorpromazine

Slightly off-topic, but there is some confusion over "Promazine hydrochloride" vs. "Chlorpromazine". Promazine HCl still has (at least) off-label uses. Could someone please clarify? Please see Talk:Promazine (Yes, I made the first talk entry, but I'm not the only one who's confused.) and contribute if you are able. Jedku (talk) 13:58, 5 December 2008 (UTC)

Confusion over name

I wanted to clarify same confusion over the brand names. In Canada we have Chlorpromazine, also known as Largactil. Stemetil is actually Prochlorperazine. This could be potentially error causing.

Thanks, Leanne RN —Preceding unsigned comment added by 139.48.25.60 (talk) 07:49, 30 January 2009 (UTC)

Citations?

For covering a drug that's been in use for nearly 60 years, this article has VERY few citations. Is there anybody who wants to tackle this problem? --Aurochs (Talk | Block)

Thorazine and Brain Rot

"Chlorpromazine (as chlorpromazine hydrochloride, abbreviated CPZ, is a highly toxic drug used to sedate and control patients, making them compliant while rotting their minds." Anyone know the story with this line in the introduction? Smells like vandalism to me.SignsFollowing (talk) 22:14, 17 June 2010 (UTC)

 Fixed Smelly indeed, good catch. I have removed it. It was entered today @ 21:28, by 96.61.85.123 (talk · contribs). Be Bold, SignsFollowing! You can fix vandalism too! -- 220.101 (talk) ^\Contribs 23:31, 17 June 2010 (UTC)

GA Review

This review is transcluded from Talk:Chlorpromazine/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: Casliber (talk · contribs) 21:39, 6 July 2010 (UTC)

Dang, I meant to improve this article myself sometime. Nevermind, I'll review it. I'll make straightforward changes as I go and try and give it a shove towards FA while I'm at it. I'll jot queries below: Casliber (talk · contribs) 21:39, 6 July 2010 (UTC)

• We call it largactil in oz. maybe it is called that elsewhere outside US so would be better in lead?

Ok MacDaid (talk) 21:43, 6 July 2010 (UTC)

• Subcutaneous injection is not advised.. - intramuscular is a more common way of giving injections like this - we don't do it anyway as it has a highly unpredictable uptake (I am a psychiatrist BTW :))

Changed. MacDaid (talk) 21:56, 6 July 2010 (UTC)

• Over 100 million people were treated but the popularity of the drug fell from the late 1960s as the severe extrapyramidal side effects and tardive dyskinesia became more of a concern. - issues (1) extrapyramidal side effects and tardive dyskinesia of CPZ are less than other typical antipsychotics, so I am not sure that 'severe' is a good adjective to add. (2) I am not sure whether it was the side effects, but being parlty superseded by thioridazine and later olanzapine were more the issue, and I am not sure if it was the 1960s when its use declined. In any case, this needs checking, citing and expanding. I am intrigued and will look into it if I get a chance. Casliber (talk · contribs) 10:06, 7 July 2010 (UTC)

I changed this because I don't think it's right. There were several drugs that came shortly after that had worse side effects, like haloperidol, I believe. I think its use declined because other more efficacious drugs were developed. MacDaid (talk) 18:05, 7 July 2010 (UTC)

agreed. Casliber (talk · contribs) 19:26, 7 July 2010 (UTC)

• From chlorpromazine a number of other similar antipsychotics were developed such as triflupromazine and trifluoperazine. - as per previous, needs checking, citing and expanding. Not sure if these are the correct drugs or the only drugs.

I am not having much luck in finding citations for this or other information that doesn't come from a drug site. MacDaid (talk) 18:05, 7 July 2010 (UTC)

I have removed this information, as it is not found elsewhere and is not necessary to the understanding of chlorpromazine. MacDaid (talk) 15:20, 8 July 2010 (UTC)

• Have added some tags.

I have either found citations or removed information that didn't seem supported anywhere. MacDaid (talk) 20:10, 7 July 2010 (UTC)

• The Interactions section has some repetition of material which needs to be streamlined. It is also a bit choppy.

I tried to fix this. MacDaid (talk) 18:05, 7 July 2010 (UTC)

I believe it is fixed. MacDaid (talk) 15:20, 8 July 2010 (UTC)

• the Dosage and administration section needs referencing.

As above, except for drug sites and repeated references to Goodman and Gilman (which a hard-to-read copy is online), there don't seem to be many sources. PMID etc have mostly articles on rats, and old ones at that. I get the feeling this is not a current area of active research. MacDaid (talk) 18:05, 7 July 2010 (UTC)

• The inline refs which use drugs.com need replacing with a proper Review Paper. Some are dubious or misworded - eg. some cases of impaired glucose tolerance may have been reported but this is very rare, especially when compared with some other agents.

Removed the refs which use drugs.com. Not having luck with replacement citations. Will keep trying. MacDaid (talk) 18:05, 7 July 2010 (UTC)

I believe this problem is fixed. MacDaid (talk) 15:20, 8 July 2010 (UTC)

Update. I think I have found references for the tagged material. MacDaid (talk) 20:11, 7 July 2010 (UTC)

Question

Since you are a psychiatrist, perhaps you can comment on some of the specialized sections, such as "Dosage and administration" and "Pharmacology" sections. Some information is sourced to Drugs and behavior: an introduction to behavioral pharmacology and may be general information not specific to chlorpromazine. Is chlorpromazine ever used as a depot medication? (I wouldn't think so, but I don't know.) I removed some information that seemed too general, such as how to dissolve chlorpromazine in oil to prepare it for IM administration. What do you think? MacDaid (talk) 17:55, 8 July 2010 (UTC)

Yeah, I agree with the removal of information such as how to mix it up for an IM injection. My free time has just been all over the place the last few days. I will have a read-through now. Sorry I haven't been more all over this one.Casliber (talk · contribs) 01:38, 9 July 2010 (UTC)

• I have to run but google "CPZE" (I might do this myself a bit later today if I get time) and look at 3rd entry (I can't get up the url as it flicks up into acrobat reader in pdf fromat) - there are some papers detailing the usage of the term -look at the reference section of that paper. Important as CPZ used as scale for other anitpsychotics. Casliber (talk · contribs) 01:47, 9 July 2010 (UTC)

This:http://pb.rcpsych.org/cgi/reprint/24/4/130.pdf seems to pertain to chlorpromazine equivalents for evaluation of depot antipsychotics rather than to the use of chlorpromazine as a depot medicine itself. Used as a "benchmark". MacDaid (talk) 12:57, 9 July 2010 (UTC)

Added as a citation. MacDaid (talk) 17:26, 9 July 2010 (UTC)

Yeah, I saw that one. I meant to say I was going to check some of the refs listed in that one which discuss the development of the term...before I got sidetracked. Casliber (talk · contribs) 20:58, 9 July 2010 (UTC)

Update - sorry about delay, got sidetracked. Will look at sections tongiht. Casliber (talk · contribs) 11:51, 16 July 2010 (UTC)

• Chlorpromazine is never used as a depot. The intramuscular injection is highly unreliable and can vary considerably in its potency (as well as being painful), and is almost never used. Intravenous administration can cause a big drop in blood pressure, so never done either. It is often administered as a syrup in hospital as it works a little quicker than tablets and patients can't spit it out as easily (the same issue has been tackled differently by the makers of risperidone and olanzapine, both of which come in wafers which dissolve on the tongue.) Casliber (talk · contribs) 14:12, 17 July 2010 (UTC)

• The dosage section needs rejigging - generally 25 mg is used for hiccups or anxiety. It is usually ineffectual in psychosis though, where people will be on anywhere from 100 mg nocte upwards. In the acutely agitated inpatient, it is often given early on twice or three times daily to take advantage of calming effect through the day, and it may also be used as a PRN medication for agitation (50-100 mg). Once a patient is more settled, one can shift the dosing to all at night before bed, to take advantage of the sedation to get to sleep and minimise its impact on daytime alertness. Higher doses, up to 1200 mg daily or higher were used 30 years ago. Nowadays the dosing is much lower. Need to find a ref for maximum but is rare to see someone above 300 mg daily. Casliber (talk · contribs) 14:28, 17 July 2010 (UTC)

• this is the article needed! I will see if I can get fulltext at work/library. Casliber (talk · contribs) 15:08, 17 July 2010 (UTC)

Curses, just spent a frustrating hour trying to navigate health service database. Am trying to contact author. Casliber (talk · contribs) 03:06, 19 July 2010 (UTC)

• adverse effects: not specific to chlopromazine but the cardiovascular risk associated with weight gain might be worth mentioning? http://jap.sagepub.com/content/16/1/21.abstract Richiez (talk) 17:16, 31 July 2010 (UTC)

Additional reviewer

I will let the primary reviewer lead the review.

Compared to the information available elsewhere, this article fails as a good article. Compared with other Wikipedia articles, the standard is lower so it could pass. I caution others not to pat ourselves on the back and be too quick to call this GA. This pains me because I generally like to be positive in Wikipedia. One helpful thing to have would be a review by a pharmacologist. Otherwise it is amateurs reviewing things written by amateurs.

One of many problems is that there is a negative bent to the article. In government package inserts, the possible side effects are near the end. Here, it is in the beginning and also near the end. There is also a lot of negative emphasis. This could be partly fixed by moving sections around but complete repair requires major re-writing.

It is not my intention to oppose GA even though I have doubts about this article. As far as length, though, it's not short. Suomi Finland 2009 (talk) 17:34, 31 July 2010 (UTC)

I agree with the above. I had ferreted out a couple of papers I am going to add. I have been busy elsewhere. But will work on it too, as well as list out more specific issues. Casliber (talk · contribs) 22:29, 31 July 2010 (UTC)

Since the article's main editor has since been indefblocked, it is best to fail the article, which I'm going to do. It can be re-nommed after all the issues are fixed, since it looks like it'll be a while until that happens based on the above. Wizardman _{Operation Big Bear} 18:36, 8 August 2010 (UTC)

(belatedly) Err...I just noticed that. A well. Might just buff it up and nominate it myself sometime. Got some interesting papers for it. Casliber (talk · contribs) 11:43, 13 August 2010 (UTC)

Synthesis?

The German Wikipedia article describes a different synthesis (probably more recent). It's worth a look! Fvasconcellos (t·c) 18:21, 18 July 2010 (UTC)

Chlopromazine related to liver dysfunction

Chlopromazine is responsible for drug induced hepatitis. Namely causing cholestasis. — Preceding unsigned comment added by 41.132.107.218 (talk) 16:40, 13 September 2011 (UTC)

Poster Image

Could this article's poster image with the eye be disturbing for people with schizophrenia viewing this article? — Preceding unsigned comment added by 75.109.159.233 (talk) 06:14, 13 April 2012 (UTC)

@75.109.159.233

Hm. I think it could be offensive. But back in the 60's they didn't care. Pikachu.447 (talk) 08:10, 28 May 2024 (UTC)

History and manufacture

There is no section, or information, in the article regarding matters such as the original mamnufacturer, who got it through FDA etc etc. I think this information is as important and relevant as the scientific data. LookingGlass (talk) 07:00, 16 July 2012 (UTC)

The article specifies the year of discovery as 1951 but the Tricyclic Antidepressants article claims it was synthesized in December of 1950. I suppose "discovery" here may refer to publication; still seems a bit odd. Lewis Goudy (talk) 16:53, 29 August 2016 (UTC)

the lead was wrong. fixed it. Jytdog (talk) 18:26, 30 August 2016 (UTC)

The synthesis section

This section lists chemical building blocks for this pharmaceutical. I added links to these chemicals so someone can start and article on these chemicals. It is very important to get to the root of how these pharmaceuticals are made. Are they made from petrochemicals? 2602:306:C518:62C0:74DE:981B:CE5E:4DE0 (talk) 00:30, 23 July 2012 (UTC)

Chemical Straight Jacket

Thorazine is a drug with a storied history in the community at large. This should be included in this article. The term "Chemical Straight Jacket" is acknowledged in this college level textbook copyright 2012:

http://books.google.com.hk/books?id=ZBxeWu_r0R8C&pg=PA320&lpg=PA320&dq=chemical+straight+jacket+thorazine&source=bl&ots=ZeBhTsKEJF&sig=bf7HHo0cNUj6m8vajJgQF-Akr7Q&hl=en&sa=X&ei=urHuUNzzL8eHkgWglYBo&ved=0CGEQ6AEwCA#v=onepage&q=chemical%20straight%20jacket%20thorazine&f=false

Why shouldn't this Wikipedia article also reflect this popular perception?

116.55.67.205 (talk) 12:25, 10 January 2013 (UTC)

Psychdrugs synthesized from Benzene derivatives

Benzene is a petrochemical and a component of gasoline and is a carcinogen. Crude Oil is the ancient feces of the dinosaurs and it is true the medicine is made out of feces. 108.81.134.196 (talk) 01:23, 8 May 2013 (UTC)

chlorpromazine has been largely superseded by the newer atypical antipsychotics,

This is only the case in the affluent west. In many part of africa, it is the only affordable ant-psychotic and is also used in injectable form as a rapid tranquilliser, frquently combined with IV diazepam. — Preceding unsigned comment added by Saklein (talk • contribs) 10:21, 20 April 2014 (UTC) It's still common in United states used as a injection or a pill for psychotic disorders of the mind — Preceding unsigned comment added by A8v (talk • contribs) 10:00, 15 July 2015 (UTC)

US generic cost

Can somebody explain why the quoted cost of generic versions of this drug is much higher in the US than elsewhere? This seems nuts. Surely drugs which are out of patent can be freely traded worldwide, so the generic price should be more or less the same everywhere. I've noticed the same thing in other drug articles. Is this something to do with FDA licensing, or is it simple protectionism at the cost of the patient? --Ef80 (talk) 22:03, 24 March 2016 (UTC)

Talk pages are not a forum for general discussions. You might be able to find the answers you are looking for at Wikipedia:Reference desk. Jytdog (talk) 22:51, 24 March 2016 (UTC)

No they cannot be freely traded world wide from what I understand (at least not among developed countries). A discussion of this would be useful. We have Prescription drug prices in the United States which I have not looked at. Doc James (talk · contribs · email) 09:51, 25 March 2016 (UTC)

Jytdog, I have no axe to grind in this matter and am not American. I certainly don't want to discuss the subject on WP talk pages. The article currently quotes completely different generic prices for the US and elsewhere without explanation, and this needs clarification. --Ef80 (talk) 00:31, 26 March 2016 (UTC)

"Thorazine shuffle" redirection

I just wanted to point out that "Thorazine shuffle" redirects to this page, which never mentions "Thorazine shuffle" except in one note that states that "Thorazine shuffle" redirects to it. This is not particularly informative. 66.76.242.44 (talk) 22:53, 14 November 2017 (UTC)

Revert

Reverted edits are both WP:FRINGE and dated (outdated). Tgeorgescu (talk) 15:24, 15 March 2021 (UTC)

WP:PRIMARY studies are WP:MEDRS violations. See also WP:MEDDATE. Tgeorgescu (talk) 12:05, 16 March 2021 (UTC)

Yes the sources are really too old. As a first generation antipsychotic, it's also expected that there can be more serious side effects than with some more recent molecules, but the article already mentions them. —PaleoNeonate – 12:16, 16 March 2021 (UTC)

True, I may even grant the point that that was true about medicines from the 1970s, but it is begging the question that it is true about medicines from 2020s. Tgeorgescu (talk) 21:03, 16 March 2021 (UTC)