Ischemic stroke destroys blood-brain barrier (BBB) integrity. There are currently no effective treatments available in the clinical setting. Post-ischemia treatment with phenothiazine drugs [combined chlorpromazine and promethazine (CþP)] has been shown to be neuroprotective in stroke. The present study determined the effect of CþP in BBB integrity. Sprague-Dawley rats were divided into the following groups (n¼8 each): (1) stroke, (2) stroke treated by CþP with temperature control, and (3) stroke treated by CþP without temperature control. Infarct volume and neurological deficits were measured to assess the neuroprotective effect of CþP. BBB permeability was determined by brain edema and Evans blue leakage. Expression of BBB integral molecules, including proteins of aquaporin-4 and -9 (AQP-4, AQP-9), matrix metalloproteinase-2 and -9 (MMP-2, MMP-9), zonula occludens-1 (ZO-1), claudin-1/5, occludin, and laminin were determined by Western blot. Stroke caused brain infarction and neurological deficits, as well as BBB damage, which were all attenuated by CþP through drug-induced hypothermia. When the reduced temperature was controlled to physiological levels, CþP still conferred neuroprotection, suggesting a therapeutic effect independent of hypothermia. Furthermore, CþP significantly attenuated the increase in AQP-4, AQP-9, MMP-2, and MMP-9 levels after stroke, and reversed the decrease in tight junction protein (ZO-1, claudin-1/5, occludin) and basal laminar protein (laminin) levels. This study clearly indicates a beneficial effect of CþP on BBB integrity after stroke, which may be independent of drug-induced hypothermia. These findings further prove the clinical target and cell-signal communication of CþP treatment, which may direct us closer toward the development of an efficacious neuroprotective therapy.Keywords hibernation-like therapeutic effect, ischemia/reperfusion, AQP-4, AQP-9, MMP-2, MMP-9, ZO-1, claudin-1, claudin-5, occludin and laminin