Perphenazine and Perphenazine Decanoate

As with many first-generation antipsychotics (FGAs), perphenazine has no unique therapeutic benefit compared to other D2 antagonists, but does have a long-acting injectable (LAI) preparation available in certain parts of the world (Belgium, Denmark, Finland, Iceland, The Netherlands, Norway, Portugal, Sweden) and a large database of plasma level information. As the FGA arm of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia study, many clinicians came to appreciate that modest perphenazine dosages are effective, that perphenazine is associated with lower metabolic risk than many second-generation antipsychotics, and that perphenazine treatment is associated with less prolactin elevation than risperidone therapy [2, 3].