The injectable form is only administered by healthcare professionals in a clinical setting. Never given into a vein.
What it treats
Which conditions is Chlorpromazine used for?
Overview
What is Chlorpromazine?
Chlorpromazine was the first antipsychotic medicine ever developed. Its discovery transformed psychiatry and made it possible, for the first time, to treat the core symptoms of psychosis with a medicine. Decades later, it remains clinically relevant.
It is listed in Kenya's Essential Medicines List 2023 and the WHO Model EML. Its value lies in its effectiveness, very low cost, and wide availability, including at health centre level in Kenya.
Chlorpromazine has a markedly sedative effect, which makes it particularly useful in situations of severe agitation where calming is part of the treatment goal alongside managing psychotic symptoms.
How it works
What does it do in the brain?
Formulations in Kenya
How is it available?
Availability across Africa
Where is it available in Africa and what is it called?
| Country | Common Brand Name(s) | Notes |
|---|---|---|
| Kenya | Largactil, generic | On KEML 2023 Level 3. Available from health centre level. |
| South Africa | Largactil, generic | On South Africa EML. Widely available. |
| Nigeria | Largactil, Chloractil, generic | Widely available across the country. |
| Uganda | Generic chlorpromazine | Available at all levels of the public health system. |
| Tanzania | Generic chlorpromazine | Available at health centres and above. |
| Ethiopia | Generic chlorpromazine | On Ethiopia EML. Widely available. |
| Ghana | Largactil, generic | Available at public facilities. |
| Rwanda | Generic chlorpromazine | Available within the national health system. |
| Zambia | Largactil, generic | Available at district hospitals and above. |
Side effects
What might you feel while taking it?
These are the most commonly reported effects. Not everyone experiences them, and many settle within the first few weeks.
- Significant sedation and drowsiness
- Dizziness and low blood pressure, particularly on standing up quickly
- Movement side effects including stiffness, slowness, or restlessness
- Dry mouth and constipation
- Sensitivity to sunlight. Skin may burn more easily.
- Weight gain
- Changes in menstrual cycle or breast changes
- Involuntary repetitive movements developing after long-term use. Report these immediately.
- Very high fever, extreme muscle rigidity, and confusion at the same time. Seek emergency care immediately.
- Unusual bruising, fever, or persistent sore throat. Contact your doctor promptly.
Risks
Important risks you should understand before taking this medicine
- Chlorpromazine injection must NEVER be given into a vein. It is administered as a deep injection into muscle only. Given into a vein it can cause severe and potentially fatal hypotension. This is an absolute rule for healthcare providers.
- Long-term use of chlorpromazine carries a significant risk of tardive dyskinesia, a condition involving involuntary repetitive movements that may be permanent. Regular movement assessment is essential for all long-term users.
- Chlorpromazine causes significant sun sensitivity. In Kenya's high-UV climate this means skin can burn severely and may develop permanent grey-purple discolouration with chronic exposure. Daily sunscreen use is a real clinical requirement for people taking this medicine.
- In elderly patients with dementia, chlorpromazine and all antipsychotics carry an increased risk of stroke and death. This must be weighed carefully before prescribing.
- Chlorpromazine can cause a rare but life-threatening condition called Neuroleptic Malignant Syndrome. Very high fever, extreme muscle rigidity, and confusion together require emergency medical care immediately.
Who should not take it
Important warnings before starting
- You are in a heavily sedated state from other medicines or substances
- You have bone marrow or blood production problems
- Known allergy to phenothiazine-type medicines
Special care needed
Situations that need extra attention
- Chlorpromazine injection is only given into muscle by a healthcare professional, never into a vein
- Elderly people with dementia face significantly higher risk on antipsychotics
- Use sunscreen and protective clothing daily in Kenya's climate
- Avoid driving or operating machinery, especially at higher doses
- Tell your doctor about any epilepsy or heart conditions
Seek specialist advice if you are pregnant or planning a pregnancy.
Present in breast milk. Specialist review is needed before breastfeeding while taking this medicine.
Other medicines
Medicines and substances that can interact with it
- Alcohol and medicines that cause drowsiness: Sedation is very significantly increased.
- Blood pressure medicines: Chlorpromazine can lower blood pressure, and combining it with antihypertensives can cause pronounced dizziness or fainting.
- Medicines for epilepsy: Chlorpromazine lowers the seizure threshold, which may affect seizure control.
Tests and follow-up
What your doctor will monitor
- Regular review of movement side effects, blood pressure, and overall treatment response
- Liver function tests periodically
- Full blood count if unexplained fever or infections occur
- Periodic eye checks for people on long-term high doses
Stopping this medicine
What happens if you stop taking it?
In Kenya
What you should know about this medicine in Kenya
Chlorpromazine has been a pillar of psychiatric care in Kenya for decades. It remains in use at county hospitals and inpatient mental health units where its strong sedative effect and low cost are valuable in acute settings.
Sun sensitivity is a particularly important consideration in Kenya where UV exposure is high year-round. People on long-term chlorpromazine should use sunscreen daily as a routine clinical precaution.
Like all antipsychotics, chlorpromazine works best as part of a broader plan that includes psychosocial support for the person and their family.
Sources
References
- Ministry of Health, Kenya. (2023). Kenya Essential Medicines List 2023. Nairobi: Ministry of Health.
- Ministry of Health, Kenya. (2023). Kenya National Medicines Formulary, 1st Edition. Nairobi: Ministry of Health.
- Leucht, S., et al. (2013). Comparative efficacy and tolerability of 15 antipsychotic drugs. The Lancet, 382(9896), 951-962.
- World Health Organization. (2023). Model List of Essential Medicines, 23rd Edition. Geneva: WHO.