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Drug-related and illness-related factors in the outcome of chlorpromazine treatment: testing a model

Published online by Cambridge University Press:  09 July 2009

T. Kolakowska ,
M. G. Gelder  and
M. W. Orr
T. Kolakowska*
Affiliation:
Department of Psychiatry, Littlemore Hospital, Oxford
M. G. Gelder
Affiliation:
Department of Psychiatry, Littlemore Hospital, Oxford
M. W. Orr
Affiliation:
Department of Psychiatry, Littlemore Hospital, Oxford
*
1Address for correspondence: Dr T. Kolakowska, University of Oxford, Department of Psychiatry, Littlemore Hospital Research Unit, Littlemore Hospital, Oxford 0X4 4XN.
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Synopsis

Patients who presented with acute psychoses and were treated with chlorpromazine were first divided into 2 groups with good (23) and poor (13) outcome. These outcome groups differed little in their initial clinical features and showed no difference in 2 indices of dopamine receptor blockade (extrapyramidal symptoms and plasma prolactin concentrations). The group which improved was then subdivided on the basis of evidence of dopaminergic blockade into 15 who had improved and also showed anti-dopamine effects (‘responders’) and 8 who had improved but showed no anti-dopamine effects (‘remitters’) The remainder were eventually classified as ‘resistant’ to the effects of the drug. The group of ‘remitters’ contained no patients with nuclear schizophrenia; the ‘responders’ were mainly nuclear schizophrenics; and the ‘resistant’ patients were schizophrenic or schizo-affective. The 3 groups who were defined in this way also differed in their subsequent clinical course. It is suggested that this scheme for dividing patients may be useful in clinical work and could also assist research workers to identify the patients who can most appropriately be studied to determine mechanisms of drug action.

Type
Research Article
Information
Psychological Medicine , Volume 10 , Issue 2 , May 1980 , pp. 335 - 343
Copyright
Copyright © Cambridge University Press 1980

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