Trilafon (Perphenazine) Side Effects

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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.

Off-Label Uses

It is also sometimes prescribed off-label for bipolar disorder and managing severe nausea and vomiting.

Perphenazine is infrequently prescribed today and has been largely replaced by lower-potency, second-generation antipsychotics. 

What is the most important information I should know about Trilafon?

  • Trilaphon can have severe side effects, including tardive dyskinesia, which may not go away after discontinuing the medication.
  • Older adults with dementia-related psychosis should not take Trilophon.

Precautions 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

Some of the most common side effects of Trilafon include:

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

Check with your doctor if any of the following side effects don't go away or are bothersome.

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

Trilafon can also have severe side effects. This includes tardive dyskinesia, a movement disorder that can be caused when taking antipsychotic medications.

Tardive dyskinesia 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.

If you experience those symptoms or any of the following serious side effects, call your doctor immediately:

  • 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

Risks for Elderly Patients with Dementia-Related Psychosis

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.

Trilafon Withdrawal Symptoms

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

The brand name Trilafon is no longer available in the U.S., but its generic version may still be prescribed. However, first-generation antipsychotics such as perphenazine are used less frequently today. Instead, other medications are often prescribed to treat symptoms of 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 still have 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.
3 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.
  1. 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

  2. U.S. Food and Drug Administration. Trilafon, brand of perphenazine, USP, tablets, injection.

  3. Maust DT, Kim HM, Seyfried LS, et al. Antipsychotics, other psychotropics, and the risk of death in patients with dementia: number needed to harmJAMA Psychiatry. 2015;72(5):438-445. doi:10.1001/jamapsychiatry.2014.3018

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.