Increased Mortality in Elderly Patients with Dementia-Related Psychosis
Elderly patients with dementia-related psychosis treated with antipsychotic drugs
are at an increased risk of death. Analyses of seventeen placebo-controlled trials
(modal duration of 10 weeks), largely in patients taking atypical antipsychotic
drugs, revealed a risk of death in drug-treated patients of between 1.6 to 1.7 times
the risk of death in placebo-treated patients. Over the course of a typical 10-week
controlled trial, the rate of death in drug-treated patients was about 4.5%,
compared to a rate of about 2.6% in the placebo group. Although the causes of
death were varied, most of the deaths appeared to be either cardiovascular (e.g.,
heart failure, sudden death) or infectious (e.g., pneumonia) in nature.
Observational studies suggest that, similar to atypical antipsychotic drugs,
treatment with conventional antipsychotic drugs may increase mortality. The
extent to which the findings of increased mortality in observational studies may be
attributed to the antipsychotic drug as opposed to some characteristic(s) of the
patients is not clear. Perphenazine is not approved for the treatment of patients
with dementia-related psychosis (see WARNINGS).
Perphenazine is an antipsychotic.
Perphenazine is indicated for use in the treatment of schizophrenia and for the control of severe nausea and vomiting in adults.
Perphenazine has not been shown effective for the management of behavioral complications in patients with mental retardation.
Media Articles Related to Perphenazine
Clozapine Best Antipsychotic for Schizophrenia?
Source: Medscape Psychiatry & Mental Health Headlines [2016.07.21]
Real-world observational data suggest clozapine is the most effective and quetiapine is the least effective in schizophrenia.
Medscape Medical News
Evista Blunts Symptoms in Women With Schizophrenia
Source: MedPage Today OB/Gyn [2016.07.21]
(MedPage Today) -- No safety issues in small study, but thromboembolic risk remains concern
Clozapine shows better efficacy in children with schizophrenia than in adults
Source: Psychology / Psychiatry News From Medical News Today [2016.07.13]
Childhood-onset schizophrenia is a rare, severe, and difficult to treat form of the disease, but a new study suggests that children show a stronger response to clozapine than to other antipsychotic...
Analysis of genetic repeats suggests role for DNA instability in schizophrenia
Source: Schizophrenia News From Medical News Today [2016.06.24]
Variations in the number of DNA sequence repeats are known to exist between individuals.
European Commission approves TREVICTA (paliperidone palmitate 3-monthly injection), for schizophrenia
Source: Schizophrenia News From Medical News Today [2016.06.02]
Janssen has announced that the European Commission (EC) has approved the use of TREVICTA® (paliperidone palmitate, a 3-'monthly injection) for the maintenance treatment of schizophrenia.
Published Studies Related to Perphenazine
Impact of second-generation antipsychotics and perphenazine on depressive symptoms in a randomized trial of treatment for chronic schizophrenia. [2011.01]
CONCLUSIONS: We found no differences between any second-generation antipsychotic and the first-generation antipsychotic perphenazine and no support for the clinical practice recommendation, but we did detect a signal indicating a small potential difference favoring quetiapine over risperidone only in patients with an MDE at baseline. (c) Copyright 2011 Physicians Postgraduate Press, Inc.
Employment outcomes in a randomized trial of second-generation antipsychotics and perphenazine in the treatment of individuals with schizophrenia. [2008.04]
Employment has been increasingly recognized as an important goal for individuals with schizophrenia. Previous research has shown mixed results on the relationship of specific antipsychotic medications to employment outcomes, with some studies finding greater benefits for second-generation antipsychotic medications (SGAs) over first-generation antipsychotic medication (FGAs)...
CYP2D6 and DRD2 genes differentially impact pharmacodynamic sensitivity and time course of prolactin response to perphenazine. [2007.11]
OBJECTIVES: We observed that CYP2D6 contributes to pharmacodynamic tissue sensitivity to perphenazine as measured by the areas under the curve (AUCs) expressed as a ratio (prolactin-AUC0-6/perphenazine-AUC0-6) in Chinese Canadians [Pharmacogenetics and Genomics 2007; 17:339-347]. As genetic heterogeneity in drug targets can influence drug response, we sought to further evaluate the contribution of CYP2D6 to pharmacodynamic sensitivity in our previous study sample in tandem with DRD2, the primary molecular target for perphenazine... CONCLUSIONS: CYP2D6 seems to be an independent contributor to pituitary pharmacodynamic tissue sensitivity to perphenazine after accounting for DRD2 functional polymorphisms. The A1 allele of the Taq1A polymorphism was previously shown to decrease D2 receptor density in vitro and in neuroimaging studies in vivo. At a given antipsychotic dose, individuals with A1 allele might thus achieve a higher DRD2 antipsychotic occupancy, which is consistent with an increased prolactin elevation in the A1/A1 genotype in this study. These findings provide a basis for further studies on the endogenous substrates of CYP2D6 and the rational selection of candidate genes for long-term consequences of antipsychotic-induced hyperprolactinemia (e.g. susceptibility to breast and prostate cancers).
CYP2D6 genotype in relation to perphenazine concentration and pituitary pharmacodynamic tissue sensitivity in Asians: CYP2D6-serotonin-dopamine crosstalk revisited. [2007.05]
OBJECTIVES: Hyperprolactinemia is a common side effect of first-generation antipsychotics mediated by antagonism of dopaminergic neurotransmission in the pituitary. Most first-generation antipsychotics are metabolized by CYP2D6 in the liver. Further, CYP2D6 is expressed in the human brain as a 5-methoxyindolethylamine O-demethylase potentially contributing to regeneration of serotonin from 5-methoxytryptamine. As dopaminergic neurotransmission is subject to regulation by serotonin, CYP2D6 may exert a nuanced (serotonergic) influence on dopaminergic tone in the pituitary. CYP2D6*10 is an allele associated with reduced enzyme function and occurs in high frequency (about 50%) in Asians. We prospectively evaluated significance of CYP2D6 genetic variation for prolactin response to perphenazine (a model first-generation antipsychotic) in Asians... CONCLUSIONS: CYP2D6 genotype is a significant contributor to perphenazine concentration in Chinese-Canadians. Importantly, prolactin response, when normalized per unit perphenazine concentration, appears to be blunted in volunteers homozygous for CYP2D6*10. We suggest that CYP2D6 genetic variation may potentially influence pharmacodynamic tissue sensitivity in the pituitary, presumably through disposition of an endogenous substrate (e.g. 5-methoxytryptamine).
Effectiveness of olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia after discontinuing perphenazine: a CATIE study. [2007.03]
CONCLUSIONS: Among this group of patients with chronic schizophrenia who had just discontinued the older antipsychotic perphenazine, quetiapine and olanzapine were more effective than risperidone, as reflected by longer time to discontinuation for any reason. In the context of other results from the CATIE study, the effectiveness and acceptability of antipsychotic drugs appears to vary considerably according to clinical circumstances.
Clinical Trials Related to Perphenazine
Lurasidone Effects on Tissue Glutamate in Schizophrenia [Recruiting]
24 individuals with schizophrenia or schizoaffective disorders, who are currently considered
stable, will be recruited, screened for entry criteria into a blinded study with a 4-week
randomization to either lurasidone, haloperidol, or perphenazine to examine
glutamate-related outcomes with lurasidone as compared to haloperidol and perphenazine.
Reducing Weight Gain and Improving Metabolic Function in Children Being Treated With Antipsychotics [Completed]
This study will test the effectiveness of two different treatments for children and
adolescents who have gained weight on their antipsychotic medications.
Comparison of Optimal Antipsychotic Treatments for Adults With Schizophrenia [Completed]
This study will compare the safety and effectiveness of three different antipsychotic
medications, as well as the use of other medications to limit treatment side effects, in
adults with schizophrenia.
A Positron Emission Tomography (PET) Study to Assess the Degree of Dopamine-2 (D2) Receptor Occupancy in the Human Brain After Single Doses of BL-1020 or Perphenazine in Healthy Male Subjects Using [11C]Raclopride as PET Tracer [Completed]
A Double-Blind, Controlled Study of Aripiprazole in Co-Morbid Schizophrenia and Cocaine Dependence [Recruiting]
The purpose of this study is to gather systematic clinical data on whether aripiprazole, a
partial dopamine agonist, beneficially affects schizophrenia plus cocaine dependence
subjects. Since aripiprazole has established effects against schizophrenia, the study
focuses on whether aripiprazole concurrently reduces co-morbid cocaine dependence in
schizophrenia plus cocaine dependence sufferers compared to a standard typical antipsychotic
treatment (perphenazine). The working hypothesis states that subjects in the aripiprazole
treatment arm of the study will give fewer cocaine positive urine specimens as compared to
the perphenazine control arm.
Reports of Suspected Perphenazine Side Effects
Completed Suicide (5),
Decreased Appetite (5),
Appendicitis Perforated (4),
Intentional Self-Injury (4),
Intestinal Perforation (4),
Maternal Exposure During Pregnancy (4),
Agitation (3), more >>
Page last updated: 2016-07-21