Compazine (prochlorperazine) is a typical antipsychotic. While effective in the conditions it treats, it is very potent and can produce unpleasant side effects, particularly at higher doses. Patients should not use this medication without doctor approval.

Compazine is used to treat a variety of conditions, including:

• Schizophrenia
• Anxiety
• Nausea and vomiting from chemotherapy
• Nausea and vomiting from radiation therapy
• Nausea and Vomiting before or after surgery
• Nausea and Vomiting from unknown causes
• Migraine headaches
• Vestibular neuritis

Compazine may be used for conditions not listed above.

This product should not be used in children or patients with dementia regardless of any other symptoms present; children are considerably more prone to severe side effects and individuals with dementia have an increased risk of death when taking any antipsychotics.

When to Use Compazine

Compazine comes in tablets, which may be taken without regard to food.

There are two general methods in which Compazine is used; very short term, sporadic use---a couple of days or less---and longer term.

In short term use, such as taking tablets to ease nausea during chemotherapy, side effects are unlikely in otherwise healthy adults.

Longer term use, such as managing schizophrenia, anxiety, or chronic nausea and vomiting from unknown causes, is more complex. It can be difficult to weigh potential benefits versus potential risks.

It is critical that a doctor be involved in treatment, both to help determine the ideal dosage as well as monitor for developing side effects. Some side effects can be quite severe and if allowed to develop may be permanent.

To treat nausea or vomiting:

• Administer 5 mg up to three or four times per day if needed.
• Dosage may increased only if needed to 10 mg three or four times per day.
• Do not exceed 40 mg per day.
• Do not exceed three consecutive days of treatment without explicit doctor approval.

For mild schizophrenia, anxiety, and similar conditions:

• Start with 5 mg taken three or four times per day; or
• Start with 10 mg taken twice per day.
• Dosage may increased only if needed.
• Do not exceed 40 mg per day.
• Treatment with 20 mg or more per day should not exceed 12 weeks.

For moderate to severe schizophrenia:

• Start with 10 mg three or four times per day.
• Dosage may be increased every few days to 50 or 75 mg.
• Rarely some patients need 100 to 150 mg.

Note that moderate to severe schizophrenic patients taking higher doses of Compazine are usually hospitalized or otherwise monitored 24 hours a day.

Potential Complications

One of the most common side effects of Compazine is sedation, which isn't necessarily a negative if worn out from nausea and vomiting. Speak with a doctor if it is severe, and use caution performing potentially-dangerous actions until effects are known.

A much more concerning side effect is extrapyramidal symptoms. This is a severe condition involving muscles and nerves; symptoms include:

• Repetitive movements
• Abnormal posture
• Tremor
• Muscle rigidity
• Shuffling walk
• Severe restlessness
• Drooling
• Facial distortions

About 2 percent of patients will experience extrapyramidal symptoms at lower doses of 5 to 10 mg. This number goes up to 40 percent at higher doses. Extrapyramidal symptoms usually reverse when treatment ends, but unfortunately not always. Speak with a doctor right away if experiencing any involuntary muscle movements. Treatment will likely end and a different medication tried.

Another serious complication of Compazine is neuroleptic malignant syndrome. Symptoms of this condition include:

• Confusion
• High fever
• Fast or irregular heartbeat
• Fluctuating blood pressure
• Excessive sweating
• Muscle stiffness
• Neck spasms

Again if the above are detected---even mildly---a doctor should be notified right away. Treatment with Compazine will likely end. Untreated, neuroleptic malignant syndrome can be fatal.