Cyamemazine

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Cyamemazine

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Medically reviewed

Laura Arias

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Cyamemazine

Quick Facts

Property Description
Active Ingredient Cyamemazine (Cyamepromazine)
Form Oral tablets, liquid solutions
Pharmacological Class Phenothiazine Antipsychotic (Neuroleptic)
Primary Functional Property Anxiolytic and Sedative
Origin Synthetic

What Type of Medicine is Cyamemazine?

Cyamemazine is a prescription-only, synthetic psychotropic medication that falls chemically into the phenothiazine class, a structural group historically used for neuroleptic activity. The active compound is identified by its International Nonproprietary Name (INN) Cyamemazine (or Cyamepromazine), possessing the chemical formula C19H21N3S.

As a centrally acting agent, Cyamemazine is categorized under the Anatomical Therapeutic Chemical (ATC) classification code N05AA06, grouping it with Phenothiazines with an aliphatic side-chain. While structurally a conventional antipsychotic, its pharmacological function is distinctive due to its balanced antagonism across dopamine D2 and multiple serotonin receptors. This broad engagement grants the drug a functional profile that is recognized in clinical practice as having prominent anxiolytic (anti-anxiety) and sedative properties.

Physical Forms and Pharmaceutical Class

Cyamemazine is supplied in various dosage forms, most commonly as solid oral tablets and pharmaceutical liquid solutions for oral intake, with an injectable or parenteral solution also existing for acute clinical use. It is a single active ingredient product. Pharmacological studies have confirmed the drug's high affinity for the histamine H1 receptor, which is directly linked to its recognized calming effects. This specific receptor targeting is a key factor that differentiates it as an agent with significant sedative capability compared to some other neuroleptic agents.

What is the General Purpose of Cyamemazine?

The general purpose of Cyamemazine is to stabilize severely disturbed emotional states and regulate disorganized thinking by modulating brain chemistry. Its unique mechanism of effect—involving potent antagonism at the serotonin 5-HT2C receptor—contributes significantly to its distinguished anxiolytic properties. This functional profile means the drug is typically employed to manage acute tension, agitation, and severe worry associated with underlying psychiatric conditions, confirming its established therapeutic use for managing intense restlessness.

Regulatory References

  1. ANSM Summary of Product Characteristics (RCP) for Cyamemazine

What side effects are possible with Cyamemazine?

Possible Side Effects and Safety Information

The official regulatory profile of Cyamemazine, a phenothiazine derivative, details potential adverse reactions categorized by frequency and the body system affected. These classifications reflect how government regulatory documents organize and communicate the medicine’s safety profile.

Frequency-Classified Adverse Reactions

The most commonly expected effects are related to the drug's sedative properties. Sedation and somnolence are listed as Very Common in official documents. Effects classified as Common include orthostatic hypotension (a drop in blood pressure upon standing), dry mouth, constipation, accommodation disorders (vision issues), and weight gain.

Classification Example Adverse Reaction (SOC)
Very Common Sedation (Nervous System)
Common Orthostatic Hypotension (Vascular)
Very Rare Agranulocytosis (Blood)
Not Known Tardive Dyskinesia (Nervous System)

Serious Safety Considerations

Regulatory information highlights the risk of several serious adverse reactions, including Neuroleptic Malignant Syndrome (NMS), a potentially life-threatening reaction. The label also documents the potential for Agranulocytosis (a severe blood disorder) and Tardive Dyskinesia, a motor disorder associated with long-term use. Additionally, there is a documented risk of QT interval prolongation (an effect on heart rhythm) and Venous Thromboembolism (VTE).

Population-Specific Notes and Restrictions

Official safety profiles indicate that older adults may have an increased susceptibility to adverse reactions, including pronounced sedation, orthostatic hypotension, and VTE. The use of Cyamemazine is strictly contraindicated in specific circumstances, such as in individuals with severe hepatic (liver) or renal (kidney) insufficiency, a history of agranulocytosis, or Parkinson’s disease. The risk of orthostatic hypotension is noted as being more frequent at the start of treatment or during dose adjustment.

Overdose and Emergency Response

Overdose Map: Overdose and when to seek help — Official Regulatory Information for Cyamemazine


Overdose Scope

Element Regulatory Statement
Documented overdose presentations Profound CNS depression progressing to coma, convulsions, extrapyramidal symptoms, and altered levels of consciousness such as sedation.
Physiological systems affected (as stated in label) Central Nervous System (CNS) and Cardiovascular System.
Dose-related or exposure-related factors (if applicable) Increased severity, including fatal outcomes, has been documented, particularly in the context of combined drugs.
Emergency-response statements (as written in official documents) Patients must seek immediate medical attention or contact emergency services upon taking an excessive dose.

Overdose Classifications (High-Level)

Classification Regulatory Statement
Severity classification (as defined in official documents) Overdose is classified as a severe event with the potential for life-threatening outcomes, specifically due to risks like coma and severe cardiovascular instability.
Overdose-context constraints (as defined in official documents) Management is defined by supportive measures because no specific antidote is known.

Resulting Overdose Structure

Official overdose statements:

  • Overdose may present with serious manifestations of Central Nervous System depression, including deep sedation and progression to coma.
  • Severe cardiovascular instability is a documented risk, characterized by hypotension and dangerous QT interval prolongation.
  • Convulsions and movement disorders are listed among the neurological signs observed in overdose cases.

Connection to the overall overdose profile: The regulatory documents define the overdose profile by strictly detailing the critical systemic risks to the Central Nervous System and Cardiovascular System, emphasizing the potential for life-threatening events such as coma and severe arrhythmias. This documented severity establishes the formal instruction that immediate medical evaluation is mandatory upon suspected excessive ingestion. Furthermore, the profile explicitly states that management involves supportive measures and monitoring because no specific antidote exists for this agent.

Therapeutic Uses of Cyamemazine

Cyamemazine is a medication with anxiolytic and sedative actions used for symptomatic relief across key domains. It is applied in addressing acute emotional and behavioral instability in psychiatric care, generally contributing to easing the overall symptom load during difficult episodes.

Cyamemazine is commonly used in conditions presenting with acute or disruptive symptom patterns, and is relevant in conditions such as schizophrenia, severe anxiety, and specific manifestations within mood disorders.


Severe Anxiety and Acute Emotional Distress

This medication is applied across domains where additional symptomatic support is needed to address intensely distressing symptoms. It is considered relevant for easing profound tension and severe worry in situations where patients experience symptoms that interfere with daily functioning.

Psychomotor Agitation and Intense Restlessness

Cyamemazine is useful in scenarios where symptoms may intensify temporarily, as it is applied to ease symptoms of increased neurological or muscular activity, such as marked agitation and uncontrolled restlessness. Used during phases of increased distress or discomfort, the drug offers symptomatic relief that may help patients cope more steadily with difficult episodes.


Quick Fact: Relief for Acute Distress Cyamemazine is often applied in clinical settings that involve acute or unstable symptom patterns when severe anxiety, agitation, and restlessness become overwhelming, supporting the patient's immediate stabilization.

Regulatory References

  1. HAS assessment of TERCIAN (cyamemazine)

Eligibility and Restrictions for Use

Cyamemazine is an antipsychotic medication primarily used to manage psychiatric conditions in adults and children over six years old. It is most commonly prescribed for the treatment of schizophrenia and for anxiety associated with psychosis. It may also be used in the short-term treatment of severe behavioral disturbances in children with agitation and aggression.


Contraindications and Precautions

Cyamemazine is contraindicated (should not be used) in patients with a known hypersensitivity to the drug, its components, or to other phenothiazines. It must also be avoided in certain medical conditions due to its mechanism of action, particularly its anticholinergic properties. These conditions include:

  • Narrow-angle glaucoma
  • Risk of urinary retention (e.g., related to urethroprostatic disorders)
  • History of agranulocytosis (a severe reduction in white blood cells)

Caution is advised for:

  • Elderly patients, especially those with dementia-related psychosis, due to an increased risk of death and cerebrovascular events.
  • Individuals with a history of seizures or conditions that lower the seizure threshold.
  • Patients with severe cardiovascular disorders or those at risk of QT interval prolongation (an electrical disturbance of the heart).

The use of cyamemazine requires careful medical evaluation and monitoring, especially when prescribing to individuals with these risk factors.

What should I know about interactions with other medicines?

Cyamemazine can interact with various other medicines and substance classes through both pharmacodynamic and pharmacokinetic mechanisms, which may alter the effects and safety profile of co-administered treatments.

Increased Central Nervous System (CNS) Effects

Concomitant use with other CNS depressants is associated with an increased risk of sedation, drowsiness, confusion, and respiratory depression. This includes medicinal product classes such as benzodiazepines, opioids, other antipsychotics, antidepressants, antihistamines, and general anesthetics.

Cardiac and Neurotoxicity Risks

Combination with agents known to prolong the QTc interval on an electrocardiogram may further increase the risk of serious heart rhythm disturbances. Cyamemazine may also potentiate the neurotoxic activities of bismuth salts.

Altered Drug Concentrations

Cyamemazine can increase the serum concentration of certain drugs, including some antidepressants and adrenergic blockers (e.g., certain beta-blockers), potentially leading to increased adverse effects from those medicines. Conversely, co-administration with antacids containing aluminum salts may lead to a decrease in the absorption of Cyamemazine, which could reduce its therapeutic efficacy.

Mechanism of Action

Cyamemazine is a phenothiazine derivative that exerts its effects by acting as an antagonist across multiple central nervous system neurotransmitter receptor systems. This diverse receptor binding profile allows the drug to modulate several central nervous system pathways.


Dopaminergic and Serotonergic Modulation

This domain involves cyamemazine's antagonism of dopamine D2 and serotonin 5-HT2A receptors, along with other serotonin subtypes (5-HT2C, 5-HT3). The modulation of these key systems results in decreased neuronal excitability within the mesolimbic and cortical pathways, modifying signaling sequences.


Histaminergic and Adrenergic System Engagement

Cyamemazine is also an antagonist at histamine H1 receptors and alpha-1 adrenergic receptors (alpha1). The H1 antagonism initiates a cascade that results in central nervous system (CNS) depression. The alpha1-blockade affects peripheral vascular tone and contributes to the resulting physiological effects of the drug.

Dosage and Administration Information

Official Administration Guidelines for Cyamemazine

These instructions outline the standard administration of Cyamemazine.


Administration Scope

Entity Official Instructions
Route of Administration Primarily Oral (tablets or solution) and Intramuscular (IM) injection (solution for injection).
Dosing Schedule & Titration Treatment begins at a low initial dose and is gradually increased (titrated) by the prescriber until a therapeutic maintenance dose is reached. The maximum daily dose must not be exceeded.
Frequency and Timing The total daily dose is typically administered in divided doses throughout the day. It is often recommended to take the largest portion of the dose at bedtime to manage daytime sedation.
Acute vs. Maintenance Use The IM injection is strictly reserved for the acute, short-term treatment of severe psychomotor agitation or psychosis. Patients must be rapidly transitioned to the oral form once the acute phase is stabilized.
Population-Specific Rules Elderly patients must be initiated on lower doses than the standard adult dose due to increased sensitivity.

Procedural Structure

The official procedure dictates a transition and titration sequence: administration commences with the parenteral (IM) route for short-term acute control, followed by a switch to the oral route for maintenance therapy. The dose must always be carefully and slowly adjusted upward, never starting at the maximum limit. This protocol defines the standardized method for initiation and management of Cyamemazine use.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Cyamemazine

Evidence for Symptomatic Relief of Acute Anxiety and Severe Distress

Research has examined the drug in studies involving adults experiencing acute anxiety, tension, and intense restlessness. The study landscape includes retrospective and prospective cohort studies, which analyze patterns observed in observational settings, alongside a limited number of Randomized Controlled Trials (RCTs) focusing on short-term outcomes. The studies primarily evaluated outcomes related to physical discomfort and outcomes reflecting daily functioning or activity level.

Studies reported measurements of symptom change over short-term periods, often focusing on relief in acute situations. Findings help contextualize how patients reported their experience related to the intensity of symptoms over the short term. However, evidence is limited by the fact that many reports are sourced from older, open-label, or pharmacological studies rather than recent, large-scale clinical trials. The evidence consistency for this symptomatic use is assigned a level of moderate by scientific reviews.


Research Evidence in Psychotic Conditions

Cyamemazine was evaluated in adults diagnosed with Schizophrenia and other Severe Mental Disorders. This research base consists mainly of retrospective cohort studies that analyze data in observational settings, and comparative studies that are often non-randomized in their design. Studies examined change in Psychotic Symptom Scores and evaluated functional aspects using tools like the Global Assessment of Functioning (GAF).

Data show patterns related to measurements of symptom change that were derived largely from observational data. The evidence consistency for this indication is assigned a level of low to moderate by scientific reviews, as some scientific literature describes limitations in the evidence regarding its antipsychotic effects, particularly at lower dose ranges. A key limitation is the lack of high-quality, well-controlled RCTs directly comparing the drug to other current standard neuroleptics, meaning comparative evidence is lacking.


Understanding Research Gaps and Uncertainty

Despite its long history of use, the research landscape for Cyamemazine has several key limitations that contribute to uncertainty. Data for long-term effects are not fully established across all indications, as follow-up durations were often limited to the acute phase. The evidence quality varies across studies, with many reports stemming from non-randomized designs. As a result, the findings describe group patterns but research does not determine whether an individual will respond similarly to the trends observed.

Key Studies & References

  1. Fiche d'information thérapeutique (Therapeutic Information Sheet) - TERCIAN (Cyamemazine Tartrate) - Haute Autorité de Santé (HAS)

Frequently Asked Questions (FAQ)

Common questions about Cyamemazine (FAQ)


Q: How quickly should I expect to feel the calming effects of Cyamemazine?

A: Official regulatory documents indicate that Cyamemazine is used for the acute, short-term management of severe agitation and anxiety. This suggests that effects may be noticeable relatively quickly when used in an acute setting. However, the official product information does not specify an exact timeframe for onset.

Q: Can you take Cyamemazine every day, or is it only for occasional use?

A: Cyamemazine is used for both short-term acute control (via injection) and for ongoing maintenance treatment (via oral form) when prescribed. Therefore, it may be taken every day for long-term management, depending on the clinical assessment and instructions provided.

Q: What happens if you suddenly stop taking Cyamemazine after using it for a while?

A: The administration guidelines in official documents emphasize that the dose should be gradually adjusted, or titrated. Because it is a centrally-acting medication, abrupt cessation is generally not recommended as it carries a risk of potential withdrawal or rebound symptoms.

Q: How long does Cyamemazine stay in your system after the last dose?

A: Based on pharmacological studies found in regulatory documents, the elimination half-life of Cyamemazine is reported to be approximately 10 hours. This is the time it takes for half of the drug to be eliminated from the body.

Q: What's the typical time frame to see the full therapeutic benefit of Cyamemazine?

A: Official guidelines outline that treatment begins at a low dose and is gradually increased by a prescriber until a therapeutic maintenance dose is achieved. This dose adjustment process implies that the full therapeutic benefit may take several days or weeks to stabilize, depending on the titration schedule.

Q: Can Cyamemazine cause changes in heart rhythm?

A: Regulatory documents acknowledge a documented risk of QT interval prolongation, which is an effect on the heart's electrical activity that can lead to rhythm disturbances. For this reason, caution is advised for patients with existing severe cardiovascular disorders.

Q: Does Cyamemazine interact with common herbal supplements like St. John's Wort?

A: The official product information lists interactions with several medicinal products but does not name every herbal supplement. However, because the drug can alter the body's metabolism, the label warns about altered drug effects, suggesting caution with co-administered treatments including herbal products.

Q: Can Cyamemazine be taken with common allergy medications like cetirizine?

A: Regulatory warnings explicitly advise caution regarding the combination of Cyamemazine with other antihistamines (which includes many allergy medications). This combination is associated with an increased risk of pronounced sedation, drowsiness, and potential respiratory depression.

Q: Are there any documented cases of Cyamemazine causing skin sensitivity to the sun?

A: While specific frequency data is not always listed, Cyamemazine belongs to the phenothiazine class of drugs. This class is generally associated with the risk of photosensitivity (increased skin sensitivity to sunlight) in class warnings.

Q: What types of mental health conditions is Cyamemazine NOT suitable for?

A: Cyamemazine is only approved for specific indications (schizophrenia, severe anxiety, and agitation). Caution is specifically advised by regulatory bodies in individuals with a history of seizures or conditions that could lower the seizure threshold.

Q: Does Cyamemazine have a potential for dependence or addiction?

A: Official information does not explicitly classify the drug as having a high dependence potential. However, due to its central nervous system activity, the risk is a safety consideration often monitored for centrally-acting psychotropic drugs, which is why abrupt cessation is not advised.

Q: What types of interactions are most concerning with Cyamemazine?

A: The most concerning interactions documented in regulatory labels are those with other CNS depressants (risk of severe sedation or respiratory depression) and agents known to prolong the QTc interval (risk of serious heart rhythm disturbances).

Q: Is it normal to feel dizzy or lightheaded when standing up on Cyamemazine?

A: Orthostatic hypotension (dizziness or lightheadedness when standing) is classified as a Common side effect in official documents. This effect is often more frequent when starting treatment or during dose adjustments.

Q: What does the research say about Cyamemazine's long-term safety profile?

A: Official regulatory reviews indicate that despite its long history of use, the data for long-term effects are not fully established across all indications. This is primarily because research follow-up durations were often limited to the acute phase of treatment.

Q: Is Cyamemazine approved for use in children or teenagers?

A: Official therapeutic indications state that Cyamemazine is approved for the treatment of severe behavioral disturbances with agitation and aggression in children over six years old.

Q: What percentage of users experience significant sedation from Cyamemazine?

A: According to official regulatory classifications, Sedation and Somnolence are categorized as Very Common adverse effects. This means these side effects are expected to occur in 1 out of 10 people or more.

Q: Does Cyamemazine require regular blood tests for monitoring?

A: The label notes the very rare but serious risk of Agranulocytosis, a severe blood disorder. The risk of this disorder highlights the importance of regular monitoring of blood cell counts, particularly when initiating treatment.

Q: Can pregnant or breastfeeding women safely use Cyamemazine?

A: Official information advises caution regarding use during pregnancy, especially the third trimester, due to potential risks of withdrawal symptoms in the newborn. Use during breastfeeding is generally not advised by official sources, as phenothiazines can be excreted in breast milk.

Q: Is there a risk of developing involuntary movements (tardive dyskinesia) with Cyamemazine?

A: Yes, Tardive Dyskinesia is a serious motor disorder documented in regulatory information as a potential adverse reaction associated with the long-term use of this class of medication. The risk is monitored as a serious safety consideration.

Q: What are the signs of a serious allergic reaction to Cyamemazine that need immediate attention?

A: Hypersensitivity (allergic reaction) to the drug is a contraindication in official documents. Symptoms of severe allergy, such as difficulty breathing, swelling, or rash, should be brought to the attention of a clinician.

Q: How long does the drowsy effect of Cyamemazine typically last?

A: The drowsy effect, caused by the drug's sedative properties, may persist for several hours. This is supported by the administration guideline recommending the largest portion of the daily dose be taken at bedtime to help manage potential daytime sedation.

How should Cyamemazine be stored and disposed of?

Official Storage and Disposal Instructions

Requirement Area Regulatory Statement
Child Protection Must be kept out of the sight and reach of children.
Temperature The product does not require any special temperature storage conditions (implying ambient room temperature storage).
Container & Protection Must be stored in the original package in order to protect from moisture.
Disposal Any unused medicinal product or waste material should be disposed of in accordance with local requirements.

Official regulatory documents define the storage for Cyamemazine by mandating that the medicine must be protected from moisture by being kept in its original packaging, though no special temperature conditions are required. The labeled profile strictly requires the product be kept out of the sight and reach of children for safety. All unused or expired product must be discarded strictly in accordance with local pharmaceutical waste regulations.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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