ATC Group: N05AB Phenothiazines with piperazine structure

Fluphenazine is an ester of the potent neuroleptic fluphenazine, a phenothiazine derivative of the piperazine type. The ester is slowly absorbed from the intramuscular site of injection and is then hydrolysed in the plasma to the active therapeutic agent, fluphenazine. It is used for the treatment and maintenance of schizophrenic patients and those with paranoid psychoses.

Perphenazine is a depressant which blocks dopamine receptors in the central nervous system. It binds to dopamine D₁ and D₂ receptors and inhibits their activity. Its antiemetic action is mainly due to the inhibition of D₂ receptors in the center of the vomiting. Perphenazine also binds to alpha adrenergic receptors and in conjunction with G proteins activate the phosphatidylinositol-calcium system.

Prochlorperazine belongs to the phenothiazine group. Prochlorperazine has a wide range of activity arising from its depressant actions on the CNS and its alpha-adrenergic blocking and weaker anti-muscarinic properties. It inhibits dopamine and prolactin-release-inhibitory factor, thus stimulating the release of prolactin.

Trifluoperazine is one of the phenothiazine class of compounds and as such has many pharmacodynamic effects which relate to its therapeutic actions and side effects. The most notable action of phenothiazines is antagonism at dopamine receptors in the CNS.