Invited review: fluphenazine augments retinal oxidative stress

Recently, fluphenazine, a phenothiazine neuroleptic, has been associated with idiosyncratic retinopathy. Neuroleptic-induced retinopathy appears to be isolated to only a few structurally related phenothiazines, suggesting that the causality is not the result of dopamine antagonism. The chemical structure of fluphenazine is very similar to that of chlorpromazine and thioridazine, agents known to produce retinopathy. Like chlorpromazine and thioridazine, fluphenazine may be oxidized by retinal cytochrome P450 and/or myeloperoxidase to an electrophile, producing injury in susceptible patients.