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Perphenazine

Also indexed as: Trilafon®

Combination drug: Triavil®, Etrafon®

Perphenazine is used to treat symptoms associated with psychiatric disorders, as well as severe nausea and vomiting in adults. It is in a class of drugs known as phenothiazine neuroleptics.

Interactions with Dietary Supplements

Lithium
Lithium is a mineral that may be present in some supplements and is also used in large amounts to treat mood disorders such as bipolar disorder (manic depression). Taking lithium medication at the same time as phenothiazine drugs might increase the risk of nerve damage resulting in delirium and seizures.1 2 Controlled research is needed to determine whether combining perphenazine and with the comparatively small amounts of lithium found in non-prescription supplements might cause similar side effects. Until more information is available, people taking perphenazine should exercise caution when supplementing with products that contain lithium.

Coenzyme Q10
Phenothiazine drugs similar to perphenazine can cause changes in heart activity in some people, which might be prevented by supplementing with coenzyme Q10.3 4 Therefore, some health practitioners may recommend coenzyme Q10 supplementation to people taking perphenazine.

Vitamin C
Taking phenothiazine drugs can stop menstruation in some women. Two women taking phenothiazines similar to perphenazine began menstruating following supplementation with 6 grams of vitamin C each day.5 Controlled studies are needed to determine whether vitamin C supplementation might benefit women specifically taking perphenazine who are experiencing menstrual changes. Some health practitioners recommend vitamin C supplementation to women who stop menstruating while taking perphenazine. Vitamin C might also enhance the effectiveness of neuroleptic drugs such as perphenazine in the treatment of schizophrenia. One uncontrolled study showed that 10 of 13 individuals experienced a reduction in disorganized thoughts, hallucinations, and suspicious thoughts when 8 grams of vitamin C was added to their daily drug therapy.6 Controlled studies are needed to show whether people taking perphenazine for schizophrenia might benefit from vitamin C supplementation.

Interactions with Foods and Other Compounds

Alcohol
Taking perphenazine and alcohol together may enhance the side effects of alcohol, such as drowsiness and dizziness, and might increase the risk of suicide.7 Consequently, people who are taking perphenazine should avoid alcohol.

Summary of Interactions for Perphenazine

Depletion or interference None known
Adverse interaction Lithium*
Side effect reduction/prevention Coenzyme Q10*
Supportive interaction None known
Reduced drug absorption/bioavailability None known
Other (see text) Vitamin C*

For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

References:

1. Drug Evaluations Subscription, Chicago, American Medical Association, Vol I, Section 3, Chapter 2, Winter, 1994.

2. Spring GK. Neurotoxicity with combined use of lithium and thioridazine. J Clin Psychiatry 1979;40:135–8.

3. Kishi T, Makino K, Okamoto T, et al. In Yamamura Y, Folkers K, Ito Y, eds. Biochemical and Clinical Aspects of Coenzyme Q, Volume 2. Amsterdam: Elsevier/North Holland Biomedical Press, 1980, 139–57.

4. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, Inc., 1997, 212.

5. Kanofsky JD, Kay SR, Lindenmayer JP, Seifter E. Ascorbic acid action in neuroleptic-associated amenorrhea. J Clin Psychopharmacol 1989;9:388–9 (letter).

6. Beauclair L, Vinogradov S, Riney SJ, et al. An adjunctive role for ascorbic acid in the treatment of schizophrenia? J Clin Psychopharmacol 1987;7:282–3.

7. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 2842–4.