Antiviral activity of chlorpromazine, fluphenazine, perphenazine, prochlorperazine, and thioridazine towards RNA-viruses. A review

• Published in: European journal of pharmacology Vol. 887; p. 173553
• Main Authors: Otręba, Michał, Kośmider, Leon, Rzepecka-Stojko, Anna
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.11.2020
• Subjects: Animals; Antipsychotic Agents - pharmacology; Antipsychotic Agents - therapeutic use; Antiviral activity; Antiviral Agents - pharmacology; Antiviral Agents - therapeutic use; Betacoronavirus - drug effects; Chlorpromazine - pharmacology; Chlorpromazine - therapeutic use; Coronavirus Infections - drug therapy; COVID-19; Fluphenazine - pharmacology; Fluphenazine - therapeutic use; Full Length; Humans; Neuroleptic drugs; Pandemics; Perphenazine - pharmacology; Perphenazine - therapeutic use; Phenothiazines; Phenothiazines - pharmacology; Phenothiazines - therapeutic use; Pneumonia, Viral - drug therapy; Prochlorperazine - pharmacology; Prochlorperazine - therapeutic use; RNA viruses; RNA Viruses - drug effects; SARS-CoV-2; Thioridazine - pharmacology; Thioridazine - therapeutic use; RNA viruses; Neuroleptic drugs; Phenothiazines; Antiviral activity
• ISSN: 0014-2999; 1879-0712; 1879-0712
• DOI: 10.1016/j.ejphar.2020.173553

In 2020 the whole world focused on antivirus drugs towards SARS-CoV-2. Most of the researchers focused on drugs used in other viral infections or malaria. We have not seen such mobilization towards one topic in this century. The whole situation makes clear that progress needs to be made in antiviral drug development. The first step to do it is to characterize the potential antiviral activity of new or already existed drugs on the market. Phenothiazines are antipsychotic agents used previously as antiseptics, anthelminthics, and antimalarials. Up to date, they are tested for a number of other disorders including the broad spectrum of viruses. The goal of this paper was to summarize the current literature on activity toward RNA-viruses of such drugs like chlorpromazine, fluphenazine, perphenazine, prochlorperazine, and thioridazine. We identified 49 papers, where the use of the phenothiazines for 23 viruses from different families were tested. Chlorpromazine, fluphenazine, perphenazine, prochlorperazine, and thioridazine possess anti-viral activity towards different types of viruses. These drugs inhibit clathrin-dependent endocytosis, cell-cell fusion, infection, replication of the virus, decrease viral invasion as well as suppress entry into the host cells. Additionally, since the drugs display activity at nontoxic concentrations they have therapeutic potential for some viruses, still, further research on animal and human subjects are needed in this field to verify cell base research. Diagrammatic summary of phenothiazine derivatives antiviral activity. All of the phenothiazines (chlorpromazine, fluphenazine, perphenazine, prochlorperazine, and thioridazine) possess antiviral activity towards RNA viruses. These drugs inhibit clathrin-dependent endocytosis, cell-cell fusion, infection, replication of the virus, decrease viral invasion as well as suppress entry into the host cells. [Display omitted] •Phenothiazines possess antiviral activity towards RNA viruses.•An antiviral activity can be achieved below toxic serum concentration.•Phenothiazines are characterized by multidirectional points of action.