Bipolar Disorder Treatment Medications Trilafon (Perphenazine) Side Effects 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. Learn about our editorial process Marcia Purse Medically reviewed by Medically reviewed by Daniel B. Block, MD on January 30, 2020 twitter linkedin Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Review Board Daniel B. Block, MD Updated on October 24, 2020 Print PhotoAlto / Frederic Cirou / Getty Images The brand name Trilafon has been discontinued in the U.S., but generic alternatives may be available. 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. 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: Constipation Decreased sweating Dizziness Drowsiness Dryness of mouth Nasal congestion Less Common Side Effects Other side effects that are less common that may occur are: 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 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 stiffness Fever Unusual tiredness or weakness Fast heartbeat Difficult or fast breathing Increased sweating Loss of bladder control Seizures Decreased thirst Confusion Eye pain Fast heartbeat or irregular pulse Rash or hives High or low blood pressure Tight throat Vision loss Swelling in your eyes, face, mouth, lips, tongue, throat, arms, hands, feet, ankles or lower legs Itching Unusually pale skin Unusual tiredness or weakness 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. Side Effects of Withdrawal Potential side effects of withdrawal from Trilafon include: 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. Was this page helpful? Thanks for your feedback! Dealing with racing thoughts? Always feeling tired? Our guide offers strategies to help you or your loved one live better with bipolar disorder. Sign up for our newsletter and get it free. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources 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. Tardy M, Huhn M, Engel RR, Leucht S. Perphenazine versus low-potency first-generation antipsychotic drugs for schizophrenia. Cochrane Database Syst Rev. 2014;(10):CD009369. doi:10.1002/14651858.CD009369.pub2 Schneider LS, Dagerman KS, Insel P. Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials. JAMA. 2005;294(15):1934-1943. doi:10.1001/jama.294.15.1934 Additional Reading Bipolar Disorder: Treatment and Drugs. Mayo Clinic (2015). Perphenazine. Medline Plus, U.S. National Library of Medicine (2011). PERPHENAZINE-Perphenazine Tablet, Film Coated. Daily Med, U.S. National Library of Medicine (2015). Phenothiazine (Oral Route, Parenteral Route, Rectal Route). Mayo Clinic (2016).