Thioridazine

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Contents

Introduction

Thioridazine (Melleril®) used to be widely used in the UK, not only as an antipsychotic but also for anxiety, agitation, and behavioural problems. However, evidence of cardiac complications (and excessive death rates in dementia when the trials were done, a not unique issue with major tranquillisers) associated with thioridazine led to the restriction of its use from Nov. 2000

Indication

  • Second-line treatment of schizophrenia in adults, under specialist supervision
    • Dose: 50-300mg/day, initially in divided doses; max. dose 600mg/day (for inpatients only)

Class Clinical Issues

Contra-indications

Dementia is probably a contraindication for any antipsychotic (fair evidence for increased mortality in long term use) and has an interesting medicolegal potential as it is unclear if following recent changes in datasheets (SPCs) and warnings from the regulatory authorities (eg FDA) any manufacturer will share liability for out of licence use (off license) use in newly commenced patients. In the UK an urgent review is taking place as of 2008.

Cautions

Side-effects

Comparison of QT interval prolongation in normal test subjects with normal doses of some antipsychotic agents illustrating differential effects most marked in this comparator group with thioridizine

Contra-indications

Cautions and Interactions

Side effects

Special advice

Pharmacology

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