Clinically relevant qtc prolongation was not detected in preliminary studies or reported in the manufacturer’s labeling Of patients requiring regular blood cell count monitoring Chlorpromazine is a low potency antipsychotic used for psychosis, schizophrenia, and manic episodes All antipsychotics carry some risk of orthostatic hypotension, defined as a ≥20 mmhg drop in systolic or a ≥10 mmhg drop in diastolic blood pressure within three minutes of standing. Chlorpromazine and other older conventional antipsychotics are more likely to induce hypotension—and more severe hypotension—than the newer, more selective dopamine antagonists (5) The effects of phenothiazine antipsychotics on cardiovascular function have been well described.
If blood pressure changes are troublesome, consider reducing the dose of the antipsychotic (and increasing it gradually if necessary) or switching to another antipsychotic less likely to. What this usually means clinically is that you have to titrate the medication. In conclusion, when considering which antipsychotic is least likely to cause hypotension, aripiprazole and lurasidone stand out as options with a significantly lower risk profile.
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