Combination drug: Triavil, Etrafon
Perphenazine is used to treat symptoms associated with psychiatric disorders, as well as severe nausea and vomiting in adults. It is in a class of drugs known as phenothiazine neuroleptics.
Summary of Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem contradictory. For clarification, read the full article for details about the summarized interactions.
 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. | Bacopa 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 |
An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.
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.
Interactions with Herbs
Bacopa
An animal study found that the effects of chlorpromazine, a drug similar to (perphenazine, prochlorperazine, thioridazine), were enhanced when a bacopa extract was given along with it.7 Until more is known, people taking medications from this family of drugs (called phenothiazines) should not take bacopa.
Interactions with Foods and Other Compounds
Alcohol
Taking perphenazine and alcohol together may enhance the side effects of alcohol, such as drowsiness and dizziness, and might increase the risk of suicide.8 Consequently, people who are taking perphenazine should avoid alcohol.
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. Ganguly DK, Malhotra CL. Some behavioral effects of an active fraction from Herpestis monniera Linn. (Brahmi). Indian J Med Res 1967;55:473–82.
8. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 2842–4.
Copyright 2007, Healthnotes, Inc., 1505 S.E. Gideon St., Suite 200, Portland, Oregon 97202, www.Healthnotes.com.
2006-09-07
