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When would Prochlorperazine be an appropriate choice for severe anxiety?
I have read this is sometimes prescribed, short-term, for "severe" anxiety. Not sure if this is true. With antidopamergic, anticholinergic, and antihistamine properties, I don't see how this is appropriate. Certainly, not a first-line agent (?).
Is short-term anxiolysis (until tolerance) simply achieved through histamine antagonism? Why not a heafty initial dose of a long acting benzo for severe anxiety?
3 Answers
- Anonymous1 decade agoFavorite Answer
I could see a doctor prescribing it if the anxiety came from a psychosis and nausea was a feature, or if the person was undergoing chemotherapy and you wanted to blunt the emotional reaction along with the nausea.
Prochlorperazine antipsycotic (blunted emotional response) activity is thought to come from blocking dopamine. Its not used much as an antipsychotic as it has a high incidence of extrapyramidal side effects, just mainly used as an antiemetic.
Buspirone (Buspar) is a drug that probably owes the lion's share of anti-anxiety action to dopamine blockade, but the marketing to this day downplays this. The drug came onto the market after the '60 Minutes' story on the problems of valium overuse. It was/is an attempt to capture the benzodiazepine leary market.
- Anonymous1 decade ago
I've read this too, but as a physician, I can only say that I've used Ativan for intractable anxiety; I've no clue why prochlorperazine would or should be more efficacious, so just my limited clinical experience with some unruly patients back in residency, I just don't recall using anything other than Ativan nor have I see prochlorperazine used for this indication.