Loading
If this is the first time anyone has visited this substance, we may be fetching live data from TGA Product Information, PBS, and state framework sources — that can take up to a minute. Cached substances load in a second or two.
Select your state to see jurisdictional framework, reporting obligations, and authority links. Substance information above is the same in every state.
A plain-language summary of the cited sources below. Informational only — not medical advice.
Chlorpromazine works by blocking dopamine receptors in the brain—particularly D2, D3, and D5 receptors, and unusually for this type of medication, D1 receptors as well. When these receptors are blocked, dopamine (a chemical messenger in the brain) can't attach to them. Initially, the brain responds by releasing more dopamine, but over time dopamine production drops substantially and brain activity in these pathways decreases. This reduction in dopamine activity is what produces the medication's effects.
The medication is approved for treating acute psychosis (such as schizophrenia, mania, or psychotic depression) and for long-term schizophrenia management. It's also used short-term for severe agitation and depression, and in terminal illness to boost pain relief and control nausea. In children, it's approved for severe behavioural disturbances associated with intellectual disability or autism, including self-injury, aggression, and overactivity. It can also be used for intractable hiccups.
Chlorpromazine has a half-life of around 30 hours, though this varies widely between people. Some research suggests elimination happens in phases—an early phase of 2–3 hours, an intermediate phase of around 15 hours, and a late phase that can extend up to 60 days.
Common side effects include sedation or sleepiness, parkinsonism (movement symptoms like tremor and stiffness), dry mouth, constipation, and akathisia (a feeling of inner restlessness). Serious adverse effects can include neuroleptic malignant syndrome (a rare but life-threatening reaction), tardive dyskinesia (involuntary repetitive movements that may persist), agranulocytosis (severe drop in white blood cells), QT prolongation (a heart rhythm change), and liver injury—sometimes cholestatic jaundice or hepatocellular damage, which has occasionally resulted in death.
Chlorpromazine should not be used in people with circulatory collapse, severe CNS depression or coma, hypersensitivity to chlorpromazine or other phenothiazines, bone marrow depression, phaeochromocytoma, or liver failure or active liver disease. Some formulations contain sodium metabisulfite, sodium sulfite, or sodium benzoate, which can cause allergic reactions including anaphylaxis and asthma episodes in susceptible people. It must not be used in children younger than 1 year due to a possible association with Sudden Infant Death Syndrome.
Common off-label uses observed in AU practice — none of these are TGA-approved indications for this substance. If the documented purpose is one of these, the prescription falls outside the TGA-approved set and may sit inside the chemical-restraint frame depending on jurisdiction and context.
These are practitioner observations, not TGA-approved indications. A use being off-label does not by itself imply a regulated restrictive practice; review the documented purpose against the observed function in context.
Tier 4 · ObservationFor prescribing by certain health practitioners Clinical criteria: Treatment criteria: Must be treated by a health practitioner who is any of: (i) a medical practitioner, (ii) an authorised PBS prescriber who is not a medical practitioner, but who is: (a) sharing care of the patient with at least one medical practitioner; (b) intending to share care of the patient with a medical practitioner.
“Chlorpromazine is a dopamine inhibitor.”
“There is a wide variation in the elimination half lives proposed by various groups, and also wide inter-patient variation. There may be several elimination phases consisting of an early phase of 2 - 3 hours, an intermediate phase of 15 hours and a late phase of up to 60 days.”
A plain-language summary of the cited sources below. Informational only — not medical advice.
Chlorpromazine is a phenothiazine antipsychotic with potent D2 dopamine receptor antagonism and high affinity for D1 receptors. This non-selective dopamine blockade in forebrain pathways initially increases dopaminergic neural activity through feedback mechanisms, followed by substantial reduction in dopamine production and synaptic availability with continued receptor occupancy. Approved indications include acute functional psychosis (schizophrenia, mania, psychotic depression), long-term schizophrenia management, short-term treatment of agitation and severe depression, control of intractable hiccough, and symptom control in terminal illness. A further indication covers severe behavioural disturbances in children with intellectual disability or autism, including self-injurious and aggressive behaviour or overactivity.
The elimination half-life shows wide inter-patient variation, with an early phase of 2–3 hours, an intermediate phase around 15 hours, and a late phase extending to 60 days; a representative mean half-life is 30 hours. Chlorpromazine is a moderate inhibitor of CYP2D6, with possible pharmacokinetic interactions when co-prescribed with CYP2D6 substrates. Common adverse effects include sedation, parkinsonism, dry mouth, constipation, and akathisia. Serious risks include neuroleptic malignant syndrome, tardive dyskinesia, agranulocytosis, QT prolongation, and hepatotoxicity (hepatocellular, cholestatic, or mixed liver injury, sometimes fatal). Contraindications include circulatory collapse, CNS depression, bone marrow depression, phaeochromocytoma, hepatic failure or active liver disease, and use in children younger than one year due to possible association with sudden infant death syndrome.
Working under the parallel aged-care framework? Aged-care equivalent →
Curated subset. The full adverse-effect list is in the TGA Product Information; click any citation above to open it.
“Some phenothiazines are moderate inhibitors of CYP2D6. There is a possible pharmacokinetic interaction between inhibitors of CYP2D6, such as phenothiazines, and CYP2D6 substrates.”