I report here an elderly woman receiving perphenazine together with terbinafine. After 1 week of terbinafine treatment she experienced extrapyramidal symptoms and, in particular, akathisia. Her symptoms did not disappear for 6 weeks, and so at 2 weeks prior to this most recent admission she had stopped taking terbinafine. However, these symptoms persisted for 3 weeks after discontinuing terbinafine. It is well known that terbinafine inhibits CYP2D6 and that perphenazine is metabolized mainly by CYP2D6. Thus, when terbinafine and perphenazine are coadministrated, the subsequent increase in the concentration of perphenazine may induce extrapyramidal symptoms. Thus, terbinafine therapy may be associated with the induction and persistence of extrapyramidal symptoms, including akathisia. This case report emphasizes the importance of monitoring drug-drug interactions in patients undergoing terbinafine and perphenazine therapy.
Aged ; Cytochrome P-450 CYP2D6 ; Female ; Humans ; Naphthalenes ; Perphenazine ; Psychomotor Agitation

There are many reports about post-anesthetic nausea and vomiting. Pst-anesthetic nausea and vomiting can cause not only severe discomfort but also many complications. McKie (1970) said that the incidence varies from 23% 82%. But nowadays, the incidence seems greatly decreased due to the development of anesthetic techniques and anesthetic agents. We studied the incidence and factors affecting nausea and vomiting in 564 patients under general anesthesia from July 1, 1975. to September 30, 1975. at Severance Hospital, The conclusions are as follows; (1) The over all incidence is 34%. (2) It is more common in women. (3) It is less common below 10 years of age. (4) It is more common after prolonged anesthesia. (5) It is most common with ether. (6) It is more common when parasympatholytic agents are used for premedication. (7) It is most common in abdominal operations. We also studied post-anesthetic headache, and the incidence was 15%. Post-anesthetic headache was most common with halothane. There are many different opinions about the effect of the prophylactic use of antiemetics for post-anesthetic nausea and vomiting. So we studied the prophylactic antiemetic effect in ether anesthesia with the use of perphenazine HCI (Trimin). The antiemetic reduced the incidence from 42% to 3% in cases using ether.
Anesthesia ; Anesthesia, General* ; Anesthetics ; Antiemetics ; Ether ; Female ; Halothane ; Headache ; Humans ; Incidence ; Nausea* ; Parasympatholytics ; Perphenazine ; Premedication ; Vomiting*

OBJECTIVE: To determine the differentiation-inducing effects of perphenazine on K562 leukemia cells. METHODS: Differentiation-Inducing effects of a phenothiazine perphenazine were evaluated by proliferation, morphology and function of K562 cells. We evaluated the effects of perphenazine on K562 cells proliferation by cellular enumeration in liquid culture assay, MTT assay and clony formation assay, the morphology by Wight-Gimesa staining, and the function by detecting CD71 through flow cytometry. RESULTS: Perphenazine enhanced the expression of CD71 on K562 cells and increased Hb content in K562 cells, while inhibited the proliferation of K562 cells. K562 cells showed differentiation morphology after the drug treatment. CONCLUSION Perphenazine possessed differentiation-inducing effects on K562 cells.
Cell Transformation, Neoplastic ; drug effects ; Flow Cytometry ; Humans ; K562 Cells ; Perphenazine ; pharmacology

BACKGROUND: Enhanced recovery protocols (ERP) provide optimal perioperative care for surgical patients. Postoperative nausea and vomiting (PONV) is common after colorectal surgery (CRS). We aim to compare the efficacy of aprepitant to a cost-effective alternative, perphenazine, as components of triple antiemetic prophylaxis in ERP patients. METHODS: Patients who underwent ERP CRS at a single institution from July 2015 to July 2017 were evaluated retrospectively. Only subjects who received aprepitant (Group 1) or perphenazine (Group 2) preoperatively for PONV prophylaxis were included. Patient characteristics, simplified Apfel PONV scores, perioperative medications, and PONV incidence were compared between the groups. PONV was defined as the need for rescue antiemetics on postoperative days (POD) 0–5. RESULTS: Five hundred ninety-seven patients underwent CRS of which 498 met the inclusion criteria. Two hundred thirty-one (46.4%) received aprepitant and 267 (53.6%) received perphenazine. The incidence of early PONV (POD 0–1) was comparable between the two groups: 44.2% in Group 1 and 44.6% in Group 2 (P = 0.926). Late PONV (POD 2–5) occurred less often in Group 1 than Group 2, respectively (35.9% vs. 45.7%, P = 0.027). After matching the groups for preoperative, procedural, and anesthesia characteristics (164 pairs), no difference in early or late PONV could be demonstrated between the groups. CONCLUSIONS: The incidence of PONV remains high despite most patients receiving three prophylactic antiemetic medications. Perphenazine can be considered a cost-effective alternative to oral aprepitant for prophylaxis of PONV in patients undergoing CRS within an ERP.
Anesthesia ; Antiemetics ; Colectomy ; Colorectal Surgery ; Humans ; Incidence ; Perioperative Care ; Perphenazine ; Postoperative Nausea and Vomiting ; Retrospective Studies

Hyposexuality after stroke has been frequently observed, but hypersexuality as a sequela of stroke has not been commonly documented. We report a patient who exhibited hypersexuality and obsessive-compulsive behaviors after stroke in the region of the left mesial frontal cortex and both basal ganglia. At 2 months after stroke, he visited psychiatric unit due to these symptoms. His motor function was almost full recovered. He was treated with fluvoxamine and perphenazine, With two-month medication, his hypersexuality and obsessive-compulsive behavior disappeared. This case may indicate that basal ganglia-thalamocortical circuit plays an important role in the mediation of sexual behavior and obsessive-compulsive behavior. Since changes in sexual activity may not be spontaneously reported, a systemic inquiry into patient's sexual functioning after infarction in frontal lobe or basal ganglia is warranted.
Basal Ganglia* ; Depression ; Fluvoxamine ; Frontal Lobe ; Humans ; Infarction ; Negotiating ; Perphenazine ; Sexual Behavior ; Stroke*

BACKGROUND: Antihistamine drugs are used widely in many conditions. Although some antihistamines may cause a photosensitive reaction,many physicians are not awae of it. OBJECTIVE: For examination of the phototoxic potential of antihistamines, we performed the Candida albiecrns test which is simple, cheap, and good for the screening of many drugs. MEHTODS: Thirty microliters of each solute of various antihistamines were applied to the Sabraud dextrose agar plate in which Candida albicans were applied diffusly. Four hours after the application, 60J/cm fo UVA was irradiated for two days. The irradiated. plates and nonirradiated control ones were incubated in a dark room for 48 hours, and examined for lear zones arround the drug, which means a positive results for the phototoxic potential of the drugs. RESULTS: Mequitazine, thiethylperazine, perphenazine and cllorromazine showed positive results, whereas others did not. An additional Candida albicans test using 0.1%, 0.01%, and 0.001% of the positive drugs revealed tht chlorpromazine, thiethylperazine aderphenazine showed positive results at 0.1%, but negative at 0.01 and 0.001%. Mequitazine was niegative at 0.1, 0.01, and 0,001%, Additional studies of the Candida albicans test using 5% and 10% of the diphenhydramine and dimenhydrinate, those were known photosensitizers but they slowed negative results at this study and revealed very weak posit,ive result in 10% diphenhydramine. CONCLUSION: A photosensitive reaction such as photoallergy and persistent light react,ion may be triggered by the phenothiazine antihistamines. Negative result in 1%, and very weak positive results in 10% diphenhydramine may be due to different mechanism of phototoxicity, or the low phototoxic potential of diphenhydrainine.
Agar ; Candida albicans* ; Candida* ; Chlorpromazine ; Dermatitis, Photoallergic ; Dermatitis, Phototoxic* ; Dimenhydrinate ; Diphenhydramine ; Glucose ; Histamine Antagonists ; Mass Screening* ; Perphenazine ; Photosensitizing Agents ; Thiethylperazine

OBJECTIVE: To investigate the patterns of antipsychotic use in China and to analyze the factors that influence antipsychotic prescriptions. METHODS: A standardized survey was conducted from May 20 to 24 2002 in five different regions of China with varying economic levels. The patterns of antipsychotic medication use were analyzed in a sample of 4,779 patients with schizophrenia. The survey gathered information on demographic characteristics, clinical profiles, and antipsychotic medications prescribed. Multiple logistic regression was used to analyze factors related to patterns of antipsychotic medication use. RESULTS: A plurality of patients with schizophrenia was treated with clozapine (39%); this was followed by risperidone, sulpride, chlorpromazine, perphenazine, and haloperidol. More than 56.3% of patients were treated with only one atypical antipsychotic. The mean daily dose of chlorpromazine was 365+/-253 mg (mean+/-standard deviation), and 6.5% of patients were treated with depot injections of typical antipsychotic medications. A total of 73.7% (n=3,523) of patients with schizophrenia received monotherapy, 24.8% (n=1,183) received two antipsychotics, 1.1% (n=52) received three antipsychotics, and one received four different antipsychotics. Patients often simultaneously received other classes of medications including anticholinergic agents, benzodiazepines, beta-blockers, antidepressants, and mood stabilizers. Economic status and clinical symptoms were the main factors that contributed to the patterns of antipsychotic prescription. CONCLUSION: The present study suggests that atypical antipsychotic medications, especially clozapine, are the primary psychiatric treatments of choice in the management of schizophrenia in China. Moreover, the economic status and clinical profile of the patient are the major factors affecting the prescription of antipsychotic medication.
Antidepressive Agents ; Antipsychotic Agents ; Benzodiazepines ; China ; Chlorpromazine ; Cholinergic Antagonists ; Clozapine ; Haloperidol ; Humans ; Logistic Models ; Perphenazine ; Prescriptions ; Risperidone ; Schizophrenia