Adverse Reactions to Phenothiazines

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Abstract
PHENOTHIAZINE derivatives are classic examples of the fact that few drugs have just one effect. Although we commonly think of these agents as clinically useful in the treatment of emotional disorders, especially schizophrenic reactions, they also have medical importance as antiemetic agents and as adjuncts to anesthetic or analgesic drugs (Table 1). In addition to these useful therapeutic effects, various phenothiazine derivatives may exhibit antihistaminic, adrenergic blocking, anticholinergic, or metabolic-endocrine actions. Such an array of pharmacodynamic actions contributes to the wide variety of adverse effects that these drugs may evoke. These complications, which have been reviewed in detail, are summarized in Table 2.1-3 Adverse behavioral effectsare sometimes seen, even though most drugs in this class are useful as antipsychotic agents. In general, the rule seems to be that the more seriously disturbed the patient, the better these drugs are tolerated. Patients with mild anxiety usually tolerate small doses

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