Key takeaways
Perphenazine and clozapine (Clozaril) are both antipsychotic medications, but they belong to different classes and have distinct uses and side effects. Perphenazine is a first-generation (typical) antipsychotic used to treat schizophrenia and severe nausea and vomiting, while clozapine is a second-generation (atypical) antipsychotic primarily used for schizophrenia that hasn't responded to other treatments. It also reduces suicidal behavior in people with schizophrenia or schizoaffective disorder. Perphenazine needs to be taken multiple times a day, while clozapine is taken once or twice daily. Common side effects for both medications include dizziness and sleepiness, however, perphenazine can cause dry mouth, while clozapine can cause watering of the mouth. Serious side effects of clozapine include seizures, heart problems, and liver problems. It can also decrease white blood cells, which increases the risk of serious infections. Because of this, clozapine is prescribed under a special program called Risk Evaluation and Mitigation Strategies (REMS) and requires regular blood tests to monitor white blood cell counts. Both medications can cause movement disorders and should be used with caution in older adults with dementia-related psychosis due to a higher risk of death.
