Key takeaways
Trifluoperazine and clozapine (Clozaril) are both used to treat schizophrenia, but they have significant differences. Trifluoperazine is a first-generation (typical) antipsychotic that primarily affects dopamine levels in the brain and is also used for anxiety. It is not recommended for long-term use due to the risk of tardive dyskinesia, a condition causing uncontrollable movements. Clozapine, on the other hand, is a second-generation (atypical) antipsychotic that affects both dopamine and serotonin levels. Because of its severe side effects, it is only reserved for cases of schizophrenia where other treatments have failed. Dangerous drops in white blood cell counts are possible with clozapine, increasing the risk of infection. Because of this, clozapine is prescribed under a special monitoring program called Risk Evaluation and Mitigation Stategies (REMS) and requires regular blood tests. While both medications can cause drowsiness and weight gain, clozapine has a broader range of serious side effects, such as seizures and heart problems, and requires more intensive monitoring. Trifluoperazine is generally taken twice daily, whereas clozapine's dosing can vary and may be split into multiple doses throughout the day. Both medications are available as low-cost generics.
