Trilafon (perphenazine) is an antipsychotic in a class called phenothiazines that is approved for use in the management of schizophrenia. It is also sometimes prescribed off-label for bipolar disorder and the management of severe nausea and vomiting.

The brand name Trilafon has been discontinued in the U.S., but generic alternatives may be available.

Perphenazine is infrequently prescribed today and has been largely replaced by lower-potency, second-generation antipsychotics. 

Cautions to Take When Using Trilafon

Trilafon is a conventional antipsychotic, also known as a typical antipsychotic, which means it is among the first generation of antipsychotic medications developed in the 1950s. This means it has more, and potentially more serious, side effects than newer, atypical antipsychotics. Still, it can be a good choice for treatment for certain people.

Because of the potential side effects that may not go away after treatment, it’s important to discuss with your doctor how the benefits of taking Trilafon may outweigh the risks. Your doctor will likely monitor you fairly closely if you are on Trilafon and decrease or stop your dose if you are showing signs of some of these negative effects.

Common Side Effects of Trilafon

Check with your doctor if any of the following side effects don’t go away or are bothersome:

  • ConstipationDecreased sweatingDizzinessDrowsinessDryness of mouthNasal congestion

Less Common Side Effects

Other side effects that are less common that may occur are:

  • Changes in menstrual periodDecreased sexual abilityIncreased sensitivity of skin to sunlight (skin rash, itching, redness or other discoloration of skin, or severe sunburn)Swelling or pain in breastsUnusual secretion of milkWeight gain

Serious Side Effects

If you have any of these serious side effects, call your doctor immediately.

They include:

  • Tardive dyskinesia, a movement disorder, that can occur and may not go away after you stop using the medicine. Signs of tardive dyskinesia include fine, worm-like movements of the tongue, or other uncontrolled movements of the mouth, tongue, cheeks, jaw, or arms and legs.Severe muscle stiffnessFeverUnusual tiredness or weaknessFast heartbeatDifficult or fast breathingIncreased sweatingLoss of bladder controlSeizures Decreased thirstConfusionEye pain Fast heartbeat or irregular pulseRash or hivesHigh or low blood pressureTight throatVision lossSwelling in your eyes, face, mouth, lips, tongue, throat, arms, hands, feet, ankles or lower legsItchingUnusually pale skinUnusual tiredness or weakness

Side Effects of Withdrawal 

Potential side effects of withdrawal from Trilafon include:

The U.S. Food and Drug Administration (FDA) issued a black box warning on all antipsychotic drugs, including Trilafon, due to the increased risk of death in older adults (those aged 65 and older) with dementia-related psychosis.

  • Dizziness
  • Nausea and vomiting
  • Stomach pain
  • Trembling of the fingers and hands
  • Tardive dyskinesia symptoms, such as lip-smacking or puckering, puffing of cheeks, rapid or fine, worm-like movements of the tongue, uncontrolled chewing movements, or uncontrolled movements of arms or legs

If you have any of these symptoms, be sure to call your doctor.

Other Medication Options for Bipolar Disorder

Medications that are typically used for bipolar disorder may include:

  • Mood Stabilizers: These include medications like Lithobid (lithium), Depakote (divalproex sodium), Tegretol (carbamazepine) and Lamictal (lamotrigine), and are prescribed to help balance your moods.
  • Antipsychotics: Newer choices include Zyprexa (olanzapine), Risperdal (risperidone), Abilify (aripiprazole) and Seroquel (quetiapine). An antipsychotic may be added to your treatment plan if you are still having mania and depressive symptoms.
  • Antidepressants: Your doctor may put you on an antidepressant to help minimize the effects of your depressive symptoms. Typical choices include Prozac (fluoxetine), Celexa (citalopram), Zoloft (sertraline), Paxil (paroxetine), Lexapro (escitalopram), Effexor (venlafaxine), Cymbalta (duloxetine) and Wellbutrin (bupropion).
  • Anti-anxiety medications: These medications can be prescribed to help with anxiety and sleeping difficulties.