Perphenazine

Safetychecker Summary for Perphenazine
(for details about the summarized interactions, read the full article)

May be Beneficial: Side effect reduction/prevention—Taking these supplements may help reduce the likelihood and/or severity of a potential side effect caused by the medication.	Coenzyme Q10*
Avoid: Adverse interaction—Avoid these supplements when taking this medication because taking them together may cause undesirable or dangerous results.	Lithium*
Check: Other—Before taking any of these supplements or eating any of these foods with your medication, read this article in full for details.	Vitamin C*
Depletion or interference	None known
Supportive interaction	None known
Reduced drug absorption/bioavailability	None known

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.

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.

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2003.