Periciazine (Neuleptil, Pericyazine): Why This Phenothiazine Is Not in U.S. Pharmacies and What Telehealth Can Still Do

Last updated: August 25, 2026

Periciazine is a piperidine phenothiazine that clinicians outside the United States still know as Neuleptil. British labels often use the spelling pericyazine. Families type either name after an old discharge list, a Canadian bottle, or a paper from a hospital stay abroad. U.S. retail pharmacies do not stock this medicine as a current option. This guide explains what periciazine is, how Health Canada still lists Neuleptil, what the Cochrane review actually found, and how telehealth can still help someone who needs an evaluation for agitation, hostility, or related symptoms.

This page is educational. It is not a diagnosis, a refill promise, or a claim that any plan will pay for a specific drug. Coverage varies by plan. Verify benefits before you book.

See conditions Klarity treats or start with online anxiety treatment if worry, restlessness, or tension is the main problem you want to discuss.

TL;DR

• DrugBank (DB01608) describes periciazine as a phenothiazine of the piperidine group used with other medicines for aggressiveness, impulsiveness, and hostility tied to psychiatric conditions such as schizophrenia. Brand name: Neuleptil. DrugBank calls it a sedative phenothiazine with weak antipsychotic properties. (DrugBank DB01608)
• Health Canada still lists Neuleptil from Erfa Canada 2012 Inc.: 5 mg and 10 mg oral capsules (DIN 01926780, 01926772) and 10 mg/mL oral drops (DIN 01926756). Consumer information last revised December 19, 2012. (Health Canada DPD: Neuleptil)
• Canadian consumer dosing notes usual initial adult doses of 5 to 20 mg in the morning and 10 to 40 mg in the evening; older adults often start at 5 mg a day and usually stay at or below 30 mg a day; children 5 years and older: 2.5 to 10 mg in the morning and 5 to 30 mg in the evening. Those figures belong to a Canadian label. They are not a U.S. prescription you can fill at a neighborhood pharmacy.
• The boxed-style warning on that leaflet: studies of medicines in this group, when used in older adults with dementia, have been associated with a higher rate of death. Neuleptil is not indicated in elderly patients with dementia.
• Cochrane review CD007479 (Matar et al., 2014) found only five trials from 1965 to 1980. Evidence quality was very low. Reviewers could not determine whether pericyazine works better than other antipsychotics. They also flagged a possible higher rate of extrapyramidal effects, again on very low-quality evidence. (Cochrane CD007479)
• Do not import unlabeled capsules or research chemical. Phenothiazines as a class still carry LiverTox cautions. (LiverTox phenothiazines)
• Medicare behavioral telehealth in the home remains available on a permanent basis, with several other Medicare telehealth flexibilities extended through December 31, 2027 (HHS page last updated February 5, 2026). Klarity’s 2,000+ licensed providers can evaluate current symptoms and discuss medicines that U.S. pharmacies still stock. (HHS telehealth policy updates)

On this page

• What is periciazine?
• Neuleptil in Canada: capsules, drops, and doses
• How this phenothiazine is described
• What the Cochrane review found
• Safety, class risks, and what not to do
• What telehealth can still do
• How Klarity fits
• FAQ

What is periciazine?

Periciazine is the international name. Pericyazine is the British Approved Name. Propericiazine appears in older papers. All three point to the same piperidine phenothiazine. PubChem lists it as CID 4747 with molecular formula C21H23N3OS and CAS 2622-26-6. DrugBank accession is DB01608.

DrugBank’s summary is specific: clinicians use it with other medications to treat aggressiveness, impulsiveness, and hostility associated with psychiatric conditions such as schizophrenia. The background section adds that it has been shown to reduce pathologic arousal and affective tension in some psychotic patients, while symptoms of abnormal mental integration are relatively unaffected. That is a historic clinical description, not a promise that the drug “fixes psychosis.”

If you found “Neuleptil” on a Canadian pharmacy label, you are looking at periciazine. If you only searched “pericyazine,” you are still looking at the same molecule.

Neuleptil in Canada: capsules, drops, and doses

Health Canada’s Drug Product Database still carries Neuleptil from Erfa Canada 2012 Inc. Listed presentations:

• 5 mg capsule, oral (DIN 01926780)
• 10 mg capsule, oral (DIN 01926772)
• 10 mg/mL oral drops (DIN 01926756)

The consumer leaflet says Neuleptil belongs to the phenothiazines and is used to control prevailing hostility, impulsiveness, and aggressiveness when used with other medicines. It describes an effect on dopamine and serotonin signaling and states that the exact mechanism is unknown.

Usual initial doses on that leaflet:

• Adults: 5 to 20 mg in the morning and 10 to 40 mg in the evening
• Older adults: start 5 mg a day; the dose is not usually more than 30 mg a day
• Children 5 years and older: 2.5 to 10 mg in the morning and 5 to 30 mg in the evening

Treat those numbers as Canadian product facts. A U.S. clinician cannot fill Neuleptil at a standard U.S. retail pharmacy. Do not copy a Canadian dose onto leftover capsules or an overseas order.

Contraindications on the same leaflet include allergy to periciazine or other phenothiazines, pheochromocytoma, severe heart or blood-vessel disease, severe kidney problems, prior brain damage, liver disease, blood-cell disorders, marked drowsiness or slow breathing from other drugs or alcohol, and planned spinal or regional anesthesia.

How this phenothiazine is described

DrugBank classifies periciazine as a piperidine phenothiazine with adrenolytic, anticholinergic, metabolic, and endocrine effects plus an action on the extrapyramidal system. It is used as an adjunct in some psychotic patients for residual hostility, impulsiveness, and aggressiveness. Like other phenothiazines, it is presumed to act mainly in subcortical areas through what older texts called a central adrenergic blockade.

Cochrane’s technical background (CD007479) describes pericyazine as a 3-cyano-10 (3-4′-hydroxypiperidinopropyl) phenothiazine, overall pharmacologically similar to chlorpromazine, though particularly sedating. The reviewers note that dopamine-receptor subtype analysis has not been performed for pericyazine and that the drug appears to induce greater noradrenergic than dopaminergic blockade. Compared with chlorpromazine, it reportedly has more potent antiemetic, antiserotonin, and anticholinergic activity. Those are review statements from 2014, not a modern U.S. label.

What the Cochrane review found

Matar, Almerie, Makhoul, Xia, and Humphreys published “Pericyazine for schizophrenia” in the Cochrane Database in 2014 (CD007479). They searched through February 2013 and included five randomized trials run between 1965 and 1980. Most trials did not report randomization, allocation concealment, or blinding in enough detail. Attrition was hard to judge.

Primary outcome, global state “not improved”:

• Versus typical antipsychotics: 2 RCTs, n = 122, RR 1.24 (95% CI 0.93 to 1.66), very low quality
• Versus atypical antipsychotics: 1 RCT, n = 93, RR 0.97 (95% CI 0.67 to 1.42), very low quality

Extrapyramidal side effects:

• Versus typical antipsychotics: 3 RCTs, n = 163, RR 0.52 (95% CI 0.34 to 0.80), very low quality
• Versus atypical antipsychotics: 1 RCT, n = 93, RR 2.69 (95% CI 1.35 to 5.36), very low quality

The authors’ conclusion is blunt. On very low-quality evidence they could not determine the effects of pericyazine versus typical or atypical antipsychotics. They also wrote that there is some evidence of a higher incidence of extrapyramidal side effects than other antipsychotics, again judged very low quality. Large, robust trials are still needed. No included study reported satisfaction or cost.

Plain-language takeaway for a patient: old, small, poorly reported trials do not give a clean “this drug is better” answer. Side-effect comparisons are also shaky. That is not a reason to order the capsules yourself.

Safety, class risks, and what not to do

The Canadian consumer leaflet lists drowsiness, dry mouth, nasal congestion, nausea, headache, menstrual changes, breast swelling and milk production in men and women, weight changes, and blurred vision. Serious listed problems include allergic reaction, neuroleptic malignant syndrome, extrapyramidal symptoms, irregular heartbeat, seizures, prolonged erection, tardive dyskinesia, blood-pressure swings, jaundice, blood clots, and akathisia.

The leaflet tells people to avoid alcohol, extreme heat, and added drowsiness from other medicines. It also warns that phenothiazines can increase the toxicity of organophosphate insecticides. Newborns exposed late in pregnancy can have breathing trouble, stiffness, floppiness, shaking, or feeding problems and may need urgent care.

LiverTox’s phenothiazine class chapter remains the right U.S. safety frame when someone is comparing older antipsychotics. Do not buy “periciazine” from a research catalog. Those products are not medicines.

If you or someone near you is in crisis, call or text 988 in the United States. For a medical emergency, call 911.

What telehealth can still do

A licensed clinician can still take a history, review old records that mention Neuleptil or pericyazine, screen for psychosis, mania, severe anxiety, and substance use, and talk through medicines that U.S. pharmacies actually carry. They can also discuss whether you need in-person labs, an ECG, or a higher level of care.

HHS states that Medicare patients can permanently receive behavioral or mental telehealth in the home, with no geographic originating-site restriction for those services, and that audio-only remains permanently allowed for Medicare behavioral telehealth. Several other Medicare telehealth flexibilities run through December 31, 2027. The policy page was last updated February 5, 2026.

Insurance may help pay for a visit. Coverage varies by plan, state, and whether the clinician is in network. Verify benefits before you book. Prior authorization is common for antipsychotics.

How Klarity fits

Klarity is an online clinic with 2,000+ licensed providers. A visit is an evaluation, not a guarantee that you will receive any named drug, including a Canadian brand. If agitation, panic, or low mood is the presenting problem, start with the condition pages or online anxiety treatment. If depression is the main issue, see depression treatment online.

See if you may qualify for a visit. Check whether your plan may cover care. Bring a photo of any old Neuleptil or pericyazine bottle so the clinician can record the name correctly and then talk about current options.

FAQ

Is periciazine the same as pericyazine?

Yes. Periciazine is the INN. Pericyazine is the BAN. Neuleptil is the brand Health Canada lists.

Can I get Neuleptil in the United States?

Not as a routine U.S. retail fill. Canada still lists capsules and drops. A U.S. telehealth visit can review symptoms and discuss available alternatives. It cannot restock a withdrawn or never-marketed U.S. SKU.

Does insurance cover periciazine?

U.S. plans typically do not have a retail periciazine product to cover. A visit for evaluation may be covered. Coverage varies. Verify benefits before you book.

Is periciazine safer than chlorpromazine?

Cochrane could not answer that with usable certainty. Five old trials, very low-quality evidence. Do not switch or stop any antipsychotic without a clinician who can see you.

What should I do if I still have leftover Neuleptil?

Do not restart it on your own. Ask a clinician or pharmacist how to dispose of it. Bring the label to your next visit.

See conditions Klarity treats

Educational only. Not medical advice. Coverage varies by plan. Verify benefits before you book. If you are in crisis, call or text 988. For emergencies, call 911.