Thioridazine, previously known under the brand name Mellaril, treats adults and children with schizophrenia. This first-generation antipsychotic, or also called typical antipsychotic, is typically used only when other antipsychotic medications haven't worked well. Thioridazine tablets are taken by mouth a few times throughout the day. The dosage depends on how well the medication is helping with your symptoms and whether you're having side effects like dry mouth, sleepiness, and nausea. Thioridazine can also cause a serious heart rhythm problem called QT prolongation, so it's not a first-choice option.
Schizophrenia when other antipsychotic medications haven't worked well or have caused bothersome side effects
Thioridazine is a first-generation, or "typical," antipsychotic. It blocks certain chemicals in the brain, like dopamine and serotonin. These chemicals help regulate mood and behavior.
Thioridazine also blocks the activity of histamine and acetylcholine. This causes many of the side effects of the medication.
Source:Â DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Phenothiazines can sometimes cause serious unwanted effects. Tardive dyskinesia or tardive dystonia (muscle movement disorders) may occur and may not go away after you stop using the medicine. Signs of tardive dyskinesia or tardive dystonia include worm-like movements of the tongue, or other uncontrolled movements of the mouth, tongue, cheeks, jaw, body, arms, or legs. Another possible serious unwanted effect is the neuroleptic malignant syndrome (NMS). Signs and symptoms of NMS include severe muscle stiffness, fever, fast heartbeat, difficult breathing, increased sweating, and loss of bladder control. You and your doctor should discuss the good this medicine will do as well as the risks of taking it.
Stop taking this medicine and get emergency help immediately if any of the following effects occur:
Rare
Symptoms of neuroleptic malignant syndrome
Confusion (severe) or coma
difficult or fast breathing
fast heartbeat
high or low (irregular) blood pressure
increased sweating
loss of bladder control
muscle stiffness (severe)
trembling or shaking
trouble in speaking or swallowing
Check with your doctor immediately if any of the following side effects occur:
More common
Inability to move eyes
increased blinking or spasms of eyelid
lip smacking or puckering
muscle spasms of face, neck, body, arms, or legs causing unusual postures or unusual expressions on face
puffing of cheeks
rapid or worm-like movements of tongue
sticking out of tongue
tic-like or twitching movements
trouble in breathing, speaking, or swallowing
uncontrolled chewing movements
uncontrolled movements of arms or legs
uncontrolled twisting movements of neck, trunk, arms, or leg
Rare
Irregular or slow heart rate
recurrent fainting
Check with your doctor as soon as possible if any of the following side effects occur:
More common
Blurred vision, change in color vision, or difficulty in seeing at night
fainting
loss of balance control
mask-like face
restlessness or need to keep moving
shuffling walk
stiffness of arms or legs
trembling and shaking of hands and fingers
Less common
Difficulty in urinating
skin rash
sunburn (severe)
Rare
Abdominal or stomach pains
aching muscles and joints
agitation, bizarre dreams, excitement, or trouble in sleeping
bleeding or bruising (unusual
clumsiness
confusion (mild)
constipation (severe)
convulsions (seizures)
dark urine
fever and chills
headaches
hot, dry skin or lack of sweating
itchy skin (severe)
muscle weakness
pain in joints
prolonged, painful, inappropriate erection of the penis
redness of hands
shivering
skin discoloration (tan or blue-gray)
sore throat and fever
sores in mouth
unusual bleeding or bruising
unusual tiredness or weakness
yellow eyes or skin
Phenothiazines may cause your urine to be dark. In most cases, this is not a sign of a serious problem. However, if your urine does become dark, discuss it with your doctor.
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Changes in menstrual period
decreased sexual ability
increased sensitivity of eyes to light
rough or “fuzzy” tongue
secretion of milk (unusual)
swelling or pain in breasts
watering of mouth
weight gain (unusual)
After you stop using this medicine, your body may need time to adjust. The length of time this takes depends on the amount of medicine you were using and how long you used it. During this time, check with your doctor if you notice dizziness, nausea and vomiting, stomach pain, trembling of the fingers and hands, or any of the following signs of tardive dyskinesia or tardive dystonia:
Inability to move eyes
lip smacking or puckering
muscle spasms of face, neck, body, arms, or legs, causing unusual body positions or unusual expressions on face
puffing of cheeks
rapid or worm-like movements of tongue
sticking out of tongue
tic-like or twitching movements
trouble in breathing, speaking, or swallowing
uncontrolled chewing movements
uncontrolled twisting or other movements of neck, trunk, arms, or legs
Although not all of the side effects listed above have been reported for all of the phenothiazines, they have been reported for at least one of them. However, since all of the phenothiazines are very similar, any of the above side effects may occur with any of these medicines.
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Less risk for weight gain than with atypical antipsychotics
Less likely to have problems with muscle movements than other antipsychotic medications
Available in many different strengths
Must take many times a day
Not a first-choice option because it has many potential side effects
Can't take with certain medications, such as fluoxetine (Prozac) and propranolol (Inderal), because it raises the risk for dangerous changes in heart rhythm
You can take thioridazine with or without food. But if it's hurting your stomach, try taking it with food to help.
You might feel sleepy when you take thioridazine. This side effect is happens more commonly in the beginning of treatment or when your dose goes up. Be careful driving or performing activities that require you to be alert until you know how this medication affects you.
It's best to avoid alcohol while you're taking thioridazine. Drinking alcohol can worsen sleepiness and dizziness, which are possible side effects of thioridazine. This can raise the risk for falls.
Thioridazine can cause your blood pressure to drop when you're moving positions, such as from sitting to standing. This can make you feel dizzy and lightheaded. Make sure to get up slowly and try to hold onto something for stability. Call a healthcare professional right away if you end up falling or hitting your head.
Although rare, some people who took thioridazine have had difficulty swallowing. This can raise the risk for choking. Make sure to take small bites of food and eat slowly to lower your risk for choking.
Let your healthcare team know right away if you have uncontrolled body movements, including fidgeting, lip-smacking, or tremors. These side effects are more likely to happen if your thioridazine dose is too high. Your care team can help ease these symptoms by lowering your dose. If needed, they might recommend other treatment options.
If you've taken thioridazine for a long time, don't stop taking it suddenly without talking to your prescriber first. Otherwise, it could lead to bothersome withdrawal symptoms, such as nausea, headache, and anxiety. If you want to stop treatment, your prescriber can help you safely do this by lowering your dose slowly over time.
Tell your healthcare team about all the medications you're taking before you start thioridazine. Also let them know about any new medications you're planning to take. It's important for your care team to check for drug interactions to make sure that all your medications are safe to take together. Taking thioridazine with certain medications, like fluoxetine (Prozac), amiodarone (Pacerone), and some antibiotics, can raise the risk for heart rhythm problems.
Thioridazine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: History of heart problems or abnormal heart rhythms (arrhythmias) | Born with QT prolongation | Slow heart rate | Low potassium or magnesium levels | Taking other medications that cause QT prolongation | Taking certain medications that affect how well the body gets rid of thioridazine
Although rare, thioridazine can affect your heart rhythm by making it take longer for your heart to pump and then relax. This is known as QT prolongation and it can be life-threatening. Because of the risk for QT prolongation, thioridazine isn't a first-choice option for schizophrenia. It's only used either when you can't take other antipsychotics because of side effects or when they don't work well for treating your schizophrenia.
Let your prescriber know about your medical history and your medications before you start thioridazine. They can check for your risk for QT prolongation. Some things that raise your risk include already having heart rhythm problems and taking other medications that can cause QT prolongation. People who were born with long QT syndrome or have an arrhythmia should avoid taking thioridazine.
Depending on your risk for QT prolongation, your prescriber might check your heart rhythm from time to time with an electrocardiogram (EKG). Call 911 right away if you feel your chest pounding, have trouble breathing, have chest pain, or feel lightheaded while you're taking thioridazine. These can be symptoms of a heart rhythm problem.
People 65 years and older with dementia sometimes have delusions and hallucinations (believing, seeing, or hearing things that aren't real). This is called dementia-related psychosis. Studies showed that older people with dementia-related psychosis have a higher risk of death if they take antipsychotic medications like thioridazine. Most of the time, the causes of death were related to heart problems or infections.
Because of this risk, thioridazine isn't approved for treating people ages 65 years and older with dementia-related psychosis. Let your prescriber know if you have dementia before you start taking thioridazine. Caregivers should also tell the prescriber if the person they're caring for has dementia.
Risk factors: Taking other antipsychotic medications | Older age | Female and 65 years or older | High thioridazine dose | Taking thioridazine for a long period of time
Antipsychotic medications like thioridazine can cause uncontrolled body movements, such as tardive dyskinesia (TD). Examples of these uncontrolled body movements include eye-twitching and lip-smacking. Your risk of tardive dyskinesia is higher the longer you take medications like thioridazine and the higher dose you take. These movement problems can become permanent. Talk to your prescriber right away if you experience any uncontrolled movements and you can't stop them.
Risk factors: Taking antipsychotic medications
Antipsychotic medications like thioridazine have been linked to a rare, but life-threatening condition called neuroleptic malignant syndrome (NMS). Seek medical help as soon as possible if you have a high fever, a lot of sweating, stiff muscles, confusion, or an irregular heartbeat. These can be signs and symptoms of NMS. Your prescriber will probably stop your treatment and recommend a different medication for you.
Risk factors: Low blood pressure | Taking medications that lower blood pressure | History of medical conditions that can lower blood pressure | High thioridazine doses
Thioridazine can cause certain side effects that can lead to a fall. These side effects include making you tired, dropping your blood pressure when you stand up, and making it more likely for you to lose your balance. Be sure to get up slowly and hold onto something stable.
Risk factors: History of low blood cell counts | Older age
Although not common, thioridazine can lower your white blood cell count. Having a lower white blood cell count than usual can put you at risk of getting an infection. This risk might be higher if you already have low white blood cell counts from other medical conditions or as a side effect from other medications.
Your prescriber might check your blood cell count regularly during the first few months that you take thioridazine. If your white blood cell levels drop too low, your prescriber might make some changes to your treatment plan, such as stopping thioridazine. Contact your prescriber if you develop any signs of infection, such as fever, tiredness, chills, cough, or trouble breathing, and if they don't go away.
Medications like thioridazine can raise the levels of a hormone in the body called prolactin. The prolactin levels can stay high with long-term treatment. Some people might experience symptoms of high prolactin levels, like changes in menstrual bleeding patterns, sexual problems, enlarge breasts in males, and milky discharge from the breast in females. Talk with your healthcare team if you're concerned about having higher prolactin levels.
People should take thioridazine during pregnancy only if the benefits outweigh the potential risks to your unborn baby. Newborn babies who are exposed to thioridazine during the third trimester of pregnancy are at a higher risk for movement problems and withdrawal symptoms. Let your care team know if you're pregnant or plan to become pregnant while you're taking thioridazine.
Adults: The typical starting dose is 50 mg to 100 mg by mouth three times a day. Your prescriber might slowly raise the dose to up to 800 mg a day to help control your symptoms. Once your symptoms are controlled, your prescriber might try to lower the dose to a maintenance dose. The typical daily dose ranges from 200 mg to 800 mg, split up into 2 to 4 doses throughout the day.
Children: The dose depends on your child's weight. The typical starting dose is 0.5 mg/kg by mouth per day, split up into smaller doses throughout the day. The prescriber might slowly raise the dose to help control symptoms. The maximum dose is 3 mg/kg per day.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking any of these medicines, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.
Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Taking other QT-prolonging medications
Abnormal heart rhythm (arrhythmias)
Take medications that block the body from breaking down thioridazine. Examples include fluoxetine (Prozac), paroxetine (Paxil), fluvoxamine, propranolol (Inderal), and pindolol
Born with defects related to the CYP2D6 enzyme (a protein in the body that helps get rid of thioridazine)
Heart conditions caused by very high or very low blood pressure
Schizophrenia when other antipsychotic medications haven't worked well or have caused bothersome side effects
Psychotic and behavioral disorders
Tourette syndrome in adults and children
Hyperactivity in children
By providing your email, you consent to receive marketing communications from GoodRx, which may include content and/or data related to men’s health, women's health, reproductive care, or sexual health. You agree to the GoodRx Terms of Use and acknowledge the Privacy Policy. You can unsubscribe at any time.
Bertilsson, L., et al. (2002). Molecular genetics of CYP2D6: Clinical relevance with focus on psychotropic drugs. British Journal of Clinical Pharmacology.
Brandt, L., et al. (2020). Antipsychotic withdrawal symptoms: A systematic review and meta-analysis. Frontiers in Psychiatry.
Crouse, E. L., et al. (2018). Dysphagia with second-generation antipsychotics: A case report and review of the literature. The Mental Health Clinician.
Dimaraki, E., et al. (2022). Hyperprolactinemia. Endocrine Society.
Drugs and Lactation Database (LactMed®). (2022). Thioridazine. National Institute of Child Health and Human Development.
Feinberg, S. M., et al. (2023). Thioridazine. StatPearls.
MedlinePlus. (2019). Histamine: The stuff allergies are made of.
Mylan Pharmaceuticals Inc. (2025). Thioridazine hydrochloride tablet, film coated [package insert]. DailyMed.
Mylan Pharmaceuticals Inc. (2025). Thioridazine hydrochloride- thioridazine hydrochloride tablet, film coated [package insert]. DailyMed.
National Heart, Lung, and Blood Institute. (2022). Long QT syndrome.
You and Your Hormones. (2023). Prolactin.
Research prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.