Not all of the following side effects were recorded with perphenazine. However, pharmacological similarity with other phenothiazine derivatives requires that each be considered. Many of these side effects can be avoided by lowering the dose.
From the nervous system and sensory organs: extrapyramidal disorder (especially dystonic) - spasm of the muscles of the back and neck, face, tongue, tonic spasm of the masticatory muscles, difficulty in speaking and swallowing, the feeling of stiffness in the throat, oculogyric crises, spasms and pain in the limbs, stiffness of arms and legs, hyperreflexia, akathisia . parkinsonism, ataxia; drowsiness, inhibition, lethargy,muscle weakness, decreased motivation, dizziness, miosis, mydriasis, blurred vision, glaucoma, pigmentary retinopathy, crystalline and corneal deposits, paradoxical reactions - exacerbation of psychotic symptoms, catalepsy, catatonic-like conditions, paranoid reactions, lethargy, inhibition, paradoxical agitation, anxiety, hyperactivity, night confusion, strange dreams, sleep disturbance. Their frequency and severity usually increase with increasing dose, but there are significant individual differences in the propensity to develop such symptoms. Extrapyramidal symptoms, as a rule, are corrected by simultaneous application of effective antiparkinsonian drugs or dose reduction. In some cases, however, these extrapyramidal reactions may persist after the abolition of perphenazine treatment.
Late dyskinesia: rhythmical, involuntary movements of the tongue, face, mouth and jaw (for example, bulging tongue, inflating the cheeks, wrinkling of the mouth, chewing movements). Sometimes this can be accompanied by involuntary limb movements.There is no effective remedy for the treatment of tardive dyskinesia. There is evidence that vermicular movements of the tongue may be an early sign of the syndrome and if treatment is stopped - this syndrome may not develop.
From the cardiovascular system: increase and decrease in blood pressure. orthostatic hypotension, change in pulse rate, tachycardia (especially with sudden significant increase in dose), bradycardia, cardiac arrest, weakness and dizziness, arrhythmia, fainting, changes in electrocardiogram, nonspecific (quinidine-like effect).
From the blood (blood, gemostaz): leukopenia, agranulocytosis, eosinophilia, hemolytic anemia, thrombopenic purpura, pancytopenia.
On the part of the digestive system: nausea, vomiting, diarrhea, constipation, anorexia, increased appetite and body weight, polyphagia, abdominal pain, dry mouth, increased salivation, liver damage (bile stasis), cholestatic hepatitis, jaundice.
Allergic reactions: skin rash, urticaria, erythema, eczema, exfoliative dermatitis, itching. hyperhidrosis, photosensitivity of the skin, bronchial asthma, fever, anaphylactoid reactions, laryngeal edema and Quinck edema, angioedema.
Other: pallor, sweating, atony of the intestine and bladder, urinary retention. urination or urinary incontinence, polyuria, nasal canal blockage, kidney damage, increased intraocular pressure, skin pigmentation, photophobia, unusual breast milk secretion, breast enlargement and galactorrhea in women, gynecomastia in men, menstrual disorder, amenorrhea, changes in libido, decrease in ejaculation, syndrome of inadequate secretion of antidiuretic hormone, false positive pregnancy test, hyperglycemia, hypoglycemia, glucosuria. peripheral edema, systemic lupus erythematosus, as a syndrome.
Malignant neuroleptic syndrome: hyperthermia, muscle rigidity, changes in mental status, autonomic instability (irregular pulse and fluctuations in blood pressure, tachycardia, sweating, and cardiac arrhythmia).