Mellaril (thioridazine) is a typical antipsychotic medicine that is only available via prescription. This medication blocks the activity of dopamine and reduces unusually high levels of excitement in the brain. Due to the severe side effects which may be experienced when using this medication, it is recommended that you follow the exact instructions received from your doctor and pharmacist.

Treatment Indications

Mellaril may be prescribed to control the symptoms of schizophrenia and other serious mental and emotional issues, such as disturbed thinking, loss of interest in life, extreme feelings, and hallucinations. While Mellaril may help to alleviate schizophrenic symptoms, it is not intended to cure schizophrenia. There are serious health risks associated with the use of this medication; it will only be prescribed if other drugs do not work and if the benefits of using this medication outweigh the risks. In general, Mellaril is considered only after at least two other medications have failed to help, or have resulted in intolerable side effects.

Finding a therapist or counselor to assist in your treatment if you are prescribed psychotropic medication may help you achieve better, longer-lasting mental health outcomes. Antipsychotic medication helps many people improve the quality of their life while experiencing debilitating symptoms, but medication in conjunction with psychotherapy can help a person better understand their condition and events that trigger symptoms, emotions, and behaviors. Several prominent, peer-reviewed studies indicate that medication taken in conjunction with psychotherapy treatment may produce better long-term results than medication alone for mental health issues.

Dosage

  • How can I take Mellaril safely?
    Mellaril comes in tablet form, as a concentrated oral solution, and as an oral suspension. When in tablet form, it is usually taken two to four times per day. A doctor may start a person out on a low dosage and then slowly increase the medication until his or her symptoms are relieved. It is important to take the medication as scheduled each day, and it should only be taken in the exact amount that has been prescribed.

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    What should I do if I forget to take a dose?
    Take the dose you missed as soon as you remember it. If you are close to the time for your next scheduled dose, however, skip the missed dose altogether and continue with your regular dosing schedule. Do not take two doses at once to make up for a missed dose. Taking more of this drug than is prescribed may lead to an overdose.
  • What should I do if I overdose?
    Contact a poison control center or seek urgent medical attention immediately. Do not try to throw up unless instructed to do so by a medical professional. Symptoms of thioridazine overdose include agitation, confusion, irregular heartbeat, sleepiness, seizures, dry mouth, slowed movements, slowed breathing, difficulty urinating, constipation, blurred vision, constriction or dilation of pupils, drooling, increased or decreased body temperature, nasal congestion, skin discoloration, loss of appetite, nausea, restlessness, and coma. If any damage to the heart is stabilized, recovery is likely. People who overdose and manage to survive for at least two days have a greater chance of recovery.

Warnings Before Use

Mellaril is often prescribed when other antipsychotic drug treatments do not work for a person. This medication has several significant risks to be aware of, including:

  • Mellaril may cause heartbeat problems or death for some people. It is very important to tell you doctor if you have or have ever had problems with your heart, including but not limited to long QT syndrome, irregular heartbeat, heart disease, high or low blood pressure, and low potassium levels.
  • You should not combine this drug with other medications that may interact with it. Medications known to interact with Mellaril include antihistamines, antidepressants, cancer medicines, blood pressure medicines, HIV medicines, anti-anxiety drugs, and drugs for the prevention and treatment of malaria. People who take Mellaril together with the antidepressant medication Pexeva (paroxetine mesylate) may experience serious heart rhythm issues or sudden death. Consult with your doctor and report any medications or supplements, including vitamins or herbal products that you are currently taking.
  • This medication is not recommended for older adults with dementia or dementia-related conditions as it may increase the risk of death.
  • If you have ever had suicidal thoughts, you should talk to your doctor before you start taking this medication. You should also mention any past history of seizures, cardiovascular complications, liver disease, kidney disease, Parkinson’s disease, or breast cancer. Let your doctor know about any severe reactions you may have had to other similar medications.
  • Long-term use of this medication may lead to a serious and potentially irreversible movement condition called tardive dyskinesia.
  • If you work with insecticides, tell your doctor before you begin taking this drug. This drug should not be used if you work with or come into regular contact with organophosphorus insecticides.

Important Information During Use

Your doctor and/or pharmacist should provide a robust set of instructions for this drug that include the following warnings:

  • You may need to have additional medical tests to monitor your heart when you take this medication. In some cases, you will need to get an electrocardiogram or laboratory tests to be sure that this medication is not having an adverse effect on your heart.
  • If you are pregnant or become pregnant while taking Mellaril, you should talk to your doctor about your medication choices. If taken during pregnancy, this drug may cause problems in newborns.
  • If you are getting dental work or surgery, you should let your dentist or surgeon know you are taking Mellaril.
  • Avoid operating heavy machinery or driving as this medication may inhibit thinking ability and alertness.
  • Do not drink alcohol if you take this medication. Alcoholic beverages can increase the side effects you experience and can make you very drowsy.
  • It is very important to notify your doctor of any irregular or fast heartbeats you experience when you take this drug.

Possible Side Effects

Serious side effects of this medication may include:

  • Confusion or seizures
  • Irregular or fast heartbeat
  • Fever, muscle stiffness, or neck cramps
  • Difficulty swallowing or breathing; tightness in throat or neck
  • Uncontrollable movements of the mouth, face, or jaw, a tongue that protrudes from the mouth, or unusual tongue movements
  • Vision problems, particularly at night
  • Rashes or hives
  • Fever, sweating, or muscle stiffness
  • Erection that lasts for hours

Less serious side effects may include, but are not limited to:

  • Dry mouth
  • Restlessness or agitation
  • Unusual dreams
  • Drooping eyelids, slurred speech, blank facial expression, or shuffling walk
  • Hair loss, rash, or itching
  • Tingling or numbness in arms, hands, ankles, or feet
  • Women may experience breast enlargement, breast milk production, and missed menstrual periods
  • Decreased sexual ability in men
  • Difficulty urinating
  • Drowsiness, dizziness, or blurred vision
  • Weight gain
  • Stomach and digestive system upset, including constipation, diarrhea, nausea, and vomiting

Withdrawal from Mellaril

Slowly reducing your Mellaril dosage over time is the best way to taper off of this medication. Your doctor may gradually reduce your dosage in order to help reduce the intensity and number of withdrawal symptoms you experience. Possible symptoms of withdrawal include:

  • Nausea, stomach upset, or diarrhea
  • Shakiness or dizziness
  • Hallucinations, delusions, and other psychotic symptoms

References:

  1. Drugs.com. (2014). Mellaril. Retrieved from http://www.drugs.com/mtm/mellaril.html
  2. Medline Plus. (2011). Thioridazine. Retrieved from http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682119.html
  3. Medline Plus. (2013). Thioridazine overdose. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/002555.htm
  4. RxList. (2009). Mellaril. Retrieved from http://www.rxlist.com/mellaril-drug.htm
  5. United States Food and Drug Administration. (2012) Medication guide: Pexeva. Retrieved from http://www.fda.gov/downloads/drugs/drugsafety/ucm088684.pdf

Page content reviewed by James Pendleton, ND.