Category C—Although occasionally published reports have linked various phenothiazine compounds with congenital defects, the bulk of the evidence suggests that the therapeutic use of these drugs is low risk for birth defects. However, according to the manufacturer, use of perphenazine in the 3rd trimester may cause extrapyramidal and/ or withdrawal symptoms in the newborn.
A 2009 review examined the potential teratogenic risk of antipsychotic drugs, including perphenazine, in pregnancy (7). No definitive association was found for an increased risk of birth defects or other adverse outcomes. However, the very limited data prevented concluding that these agents were safe in pregnancy.
Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic function, concomitant disease or other drug therapy.
2019 BEE℞S Recommendation: Avoid, except in schizophrenia or bipolar disorder. Increased risk of CVA and greater rate of cognitive decline and mortality in persons with dementia. Avoid antipsychotics for behavioral problems of dementia or delirium unless nonpharmacological options have failed or are not possible and the older adult is threatening substantial harm to self or others.
No dosage adjustment necessary.
No dosage adjustment necessary.
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Last updated August 16 2023 14:43:53. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.