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. Prochlorperazine Suppositories, USP is not approved for the treatment of patients with dementia-related psychosis (see
Prochlorperazine is a clear, pale yellow, viscous liquid. It is sensitive to light, very slightly soluble in water, freely soluble in alcohol, in chloroform, and in ether.
Each suppository, for rectal administration, contains 25 mg of prochlorperazine; with glycerin, glyceryl monostearate, hydrogenated coconut oil fatty acids, hydrogenated palm kernel oil fatty acids.
Prochlorperazine 25 mg suppositories are indicated in the control of severe nausea and vomiting in adults.
Published Studies Related to Prochlorperazine
Randomized Controlled Trial of Ondansetron vs. Prochlorperazine in Adults in the Emergency Department. [2011.02]
OBJECTIVE: To compare the effectiveness of ondansetron and prochlorperazine to treat vomiting. Secondary objectives were the effectiveness of ondansetron and prochlorperazine to treat nausea and their tolerability... CONCLUSION: Prochlorperazine and ondansetron appear to be equally effective at treating vomiting in the emergency department.
Clinical outcomes of children treated with intravenous prochlorperazine for migraine in a pediatric emergency department. [2010.08]
BACKGROUND: Prochlorperazine is the only treatment that has been studied so far in a randomized controlled trial and found to reduce pain at 1 h in children with migraine who presented to an emergency department (ED). OBJECTIVE: To evaluate the rate of treatment failure associated with prochlorperazine used in children with severe migraine in a pediatric ED... CONCLUSION: There was a treatment failure rate of 14% with the use of prochlorperazine in association with diphenhydramine for severe migraine in children seen in a pediatric ED. Copyright 2010 Elsevier Inc. All rights reserved.
A prospective, randomized trial of intravenous prochlorperazine versus subcutaneous sumatriptan in acute migraine therapy in the emergency department. [2010.07]
STUDY OBJECTIVE: Intravenous (IV) prochlorperazine with diphenhydramine is superior to subcutaneous sumatriptan in the treatment of migraine patients presenting to the emergency department (ED)... CONCLUSION: IV prochlorperazine with diphenhydramine is superior to subcutaneous sumatriptan in the treatment of migraine. Copyright 2009 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.
Randomized evaluation of octreotide vs prochlorperazine for ED treatment of migraine headache. [2009.02]
Patients with headaches account for approximately 2% of all ED visits, with migraines being the most common defined primary headache syndrome. Our goals were to evaluate the efficacy of intravenous octreotide (OC) for the treatment of migraines, when compared to standard therapy with prochlorperazine... CONCLUSION: Prochlorperazine was statistically superior to octreotide in clinical success rate and decrease in pain in migraine patients but caused more restlessness and sedation.
Clinical Outcomes of Children Treated with Intravenous Prochlorperazine for Migraine in a Pediatric Emergency Department. [2009.01.14]
Background: Prochlorperazine is the only treatment that has been studied so far in a randomized controlled trial and found to reduce pain at 1 h in children with migraine who presented to an emergency department (ED). Objective: To evaluate the rate of treatment failure associated with prochlorperazine used in children with severe migraine in a pediatric ED...
Clinical Trials Related to Prochlorperazine
Prochlorperazine Versus Acetaminophen, Aspirin, and Caffeine for the Treatment of Acute Migraine [Terminated]
The objective of this randomized, double blind study is to demonstrate that one dose oral
"excedrin migraine" (acetaminophen, aspirin and caffeine) is not inferior when compared to
one dose of intravenous prochlorperazine for the treatment of acute migraine headaches in
the emergency department.
Hydromorphone Versus Prochlorperazine + Diphenhydramine for Acute Migraine [Recruiting]
Opioids are commonly used to treat migraine in North American Emergency Departments. We are
comparing efficacy and adverse events of hydromorphone, an opioid, to that of
prochlorperazine, a dopamine antagonist with known efficacy in migraine. Prochlorperazine
will be combined with diphenhydramine to prevent adverse events.
Prochlorperazine vs Imitrex for Acute Migraine in the Emergency Department [Completed]
ED patients with acute migraine will be randomized to either prochlorperazine and Bendaryl
OR imitrex. VAS for pain will be monitored, along with side effects. Primary outcome measure
is improvement in pain scales between the groups.
Ondansetron vs Prochlorperazine for Nausea and Vomiting in the Emergency Department [Completed]
This study will compare the effect of prochlorperazine and ondansetron for the treatment of
nausea and vomiting in the emergency department.
Staccato Prochlorperazine in Patients With Migraine Headache [Completed]
Reports of Suspected Prochlorperazine Side Effects
Drug Ineffective (15),
Cerebrovascular Accident (13),
Rash Pruritic (12),
Blood Cholesterol Increased (11),
Rash Pustular (11), more >>
PATIENT REVIEWS / RATINGS / COMMENTS
Based on a total of 1 ratings/reviews, Prochlorperazine has an overall score of 2. The effectiveness score is 6 and the side effect score is 4. The scores are on ten point scale: 10 - best, 1 - worst.
Prochlorperazine review by 36 year old female patient
|Overall rating:|| || |
|Effectiveness:|| || Moderately Effective|
|Side effects:|| || Severe Side Effects|
|Condition / reason:|| || nausea|
|Dosage & duration:|| || 5mg taken 3 daily for the period of 2 days|
|Other conditions:|| || migraine|
|Other drugs taken:|| || none|
|Benefits:|| || i was experiencing nausea without vomiting. The doctor prescribed stemetil 3x daily. The first day the nausea was largely alleviated by the taking the stemetil.|
|Side effects:|| || The second day of taking stemetil i began to experience unpleasant anxiety and a cramping sensation in my muscles, particularly my arms. This worsened throughout the day and I found myself uncontrollably flexing my muscles and not being able to control it. |
|Comments:|| || My GP prescribed stemetil for the nausea associated with a migraine. 5 mg x 3 a day. After experiencing the symptoms as described above, I returned to the Doctor. He injected me with something? which counteracted the uncontrollable cramping I was experiencing. |
Page last updated: 2011-12-09