Thorazine Side Effects With Bipolar Disorder

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Thorazine (chlorpromazine) is a medication that may sometimes be used by doctors in inpatient settings to control agitation and mania in people who have bipolar disorder. It is used infrequently, but when it is used for bipolar disorder, it is used to address symptoms of mania, psychosis, or agitation and not for long-term bipolar disorder management.

What Is Thorazine?

Thorazine (chlorpromazine) is an antipsychotic drug that may be used infrequently for some symptoms of bipolar disorder, as well as for schizophrenia and other disorders involving psychotic symptoms.

Antipsychotic medications such as Thorazine, an older drug, as well as some of the newer antipsychotics, can be life-saving for people with bipolar disorder. For these people, the benefits of these drugs typically outweigh their risks.

Thorazine is not recommended for patients aged 65 and older with dementia-related psychosis. The Food and Drug Administration (FDA) issued a black box warning on all antipsychotic drugs, including Thorazine, due to the increased risk of death in older adults.

Common Side Effects

Check with your doctor if any of the following side effects continue or are bothersome:

  • Constipation
  • Decreased sweating
  • Dizziness
  • Drowsiness
  • Dryness of mouth
  • Nasal congestion

Less Common Side Effects

Check with your doctor if any of the following side effects continue or are bothersome:

  • Changes in menstrual period
  • Decreased sexual ability
  • Increased sensitivity of skin to sunlight (skin rash, itching, redness or other discoloration of skin, or severe sunburn)
  • Swelling or pain in breasts
  • Unusual secretion of milk
  • Weight gain (unusual)

Along with their needed effects, phenothiazines can sometimes cause serious side effects. Tardive dyskinesia (a movement disorder) may 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.

Other serious but rare side effects may also occur. You and your doctor should discuss the good this medicine will do as well as the risks of taking it.

Rare but serious side effects can include:

  • Difficulty breathing
  • Fast heartbeat
  • Fever
  • Increased sweating
  • Loss of bladder control
  • Seizures (which can be an indication of neuroleptic malignant syndrome or a separate side effect in and of itself)
  • Severe muscle stiffness
  • Unusual tiredness or weakness

Notify Your Doctor Immediately

If you experience any of the following side effects, notify your doctor immediately:

More common: Lip-smacking or puckering; involuntary puffing of cheeks; rapid or fine, worm-like movements of tongue; uncontrolled chewing movements; uncontrolled movements of arms or legs

Rare: Convulsions (seizures); difficult or fast breathing; fast heartbeat or irregular pulse; fever; high or low blood pressure; increased sweating; loss of bladder control; muscle stiffness (severe); unusually pale skin; unusual tiredness or weakness

Notify Your Doctor as Soon as Possible

If you experience any of the following side effects, notify your doctor as soon as possible:

More common: Blurred vision, change in color vision, or difficulty in seeing at night, difficulty in speaking or swallowing, fainting, inability to move eyes, loss of balance control, mask-like face, muscle spasms (especially of face, neck, and back), or restlessness or need to keep moving.

Also notify your doctor as soon as possible if you experience shuffling walk, stiffness of arms or legs, tic-like or twitching movements, trembling and shaking of hands and fingers, twisting movements of body, or weakness of arms and legs.

Less common: Difficulty in urinating; skin rash; sunburn (severe)

Rare: Abdominal or stomach pains, aching muscles and joints, confusion, fever and chills, hot or dry skin, lack of sweating, or muscle weakness.

Other rare side effects that warrant contacting your doctor include nausea, vomiting, diarrhea, painful, inappropriate penile erection (continuing); skin discoloration (tan or blue-gray); skin itching (severe), sore throat and fever, unusual bleeding or bruising, or yellow eyes or skin.

Withdrawal Side Effects

Dizziness, nausea and vomiting, stomach pain, trembling of the fingers and hands, or any of the following symptoms of tardive dyskinesia:

  • Lip-smacking or puckering
  • Involuntary puffing of cheeks
  • Rapid or fine, worm-like movements of the tongue
  • Uncontrolled chewing movements
  • Uncontrolled movements of arms or legs

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

1 Source
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Schneider LS, Dagerman KS, Insel P. Risk of death with atypical antipsychotic drug treatment for dementia: Meta-analysis of randomized placebo-controlled trialsJAMA. 2005;294(15):1934-1943. doi:10.1001/jama.294.15.1934

Additional Reading
  • National Library of Medicine

By Marcia Purse
Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing.