Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-19T03:48:24.611Z Has data issue: false hasContentIssue false
  • English
  • Français

Propranolol in Schizophrenia

II. Clinical and Biochemical Aspects; of Combining Propranolol with Chlorpromazine

Published online by Cambridge University Press:  29 January 2018

M. Peet ,
D. N. Middlemiss  and
R. A. Yates
M. Peet
Affiliation:
ICI Ltd, Pharmaceuticals Division, and Clinical Assistant, Parkside Hospital, Macclesfield, Cheshire and St Edward's Hospital, Cheddleton, Leek, Staffordshire
D. N. Middlemiss
Affiliation:
Clinical Research and Bioscience Departments, ICI Ltd, Pharmaceuticals Division, Alderley Park, Macclesfield, Cheshire SK10 9TG
R. A. Yates
Affiliation:
Clinical Research and Bioscience Departments, ICI Ltd, Pharmaceuticals Division, Alderley Park, Macclesfield, Cheshire SK10 9TG
Get access Rights & Permissions [Opens in a new window]

Summary

Ten hospitalized chronic schizophrenic patients were given chlorpromazine alone and chlorpromazine plus high dose propranolol in two 7-week treatment periods according to a randomized crossover design. In the six patients who completed the whole study, plasma levels of chlorpromazine and chlorpromazine sulphoxide, total serum levels of neuroleptic and serum levels of prolactin were consistently and significantly elevated during treatment with chlorpromazine plus propranolol relative to levels during treatment with chlorpromazine alone. These effects are sufficient to explain previously reported clinical improvement in schizophrenic patients given propranolol in addition to neuroleptics.

Type
Papers
Information
The British Journal of Psychiatry , Volume 139 , Issue 2 , August 1981 , pp. 112 - 117
Copyright
Copyright © Royal College of Psychiatrists, 1981 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Beumont, P. J. V., Corker, C. S., Friesen, H. G., Kolakowska, T., Mandelbrote, B. M., Marshall, J., Murray, M. A. F. & Wiles, D. H. (1974) The effects of phenothiazines on endocrine function II: Effects in men and post-menopausal women. British Journal of Psychiatry, 124, 420–30.Google Scholar
Clark, M. L., Ramsey, R., Rahhal, D. K., Serafetinides, E. A., Wood, F. D. & Costiloe, J. P. (1972) Chlorpromazine in chronic schizophrenia. Archives of General Psychiatry, 27, 479–83.CrossRefGoogle ScholarPubMed
Cohen, B. M., Lipinski, J. F., Pope, H. G., Harris, P. Q. & Altesman, R. I. (1980) Neuroleptic blood levels and therapeutic effect. Psychopharmacology, 70, 191–3.Google Scholar
Cooper, T. B. (1978) Plasma level monitoring of antipsychotic drugs. Clinical Pharmacokinetics, 3, 14—38.Google Scholar
Creese, I. & Snyder, S. H. (1977) A simple and sensitive radioreceptor assay for antischizophrenic drugs in blood. Nature, 270, 180–2.CrossRefGoogle ScholarPubMed
Curry, S. H. (1976) Gas-chromatographic methods for the study of chlorpromazine and some of its metabolites in human plasma. Psychopharmacology Communications, 2, 1—15.Google Scholar
De Rivera, J. L., Lal, S., Ettigi, P., Hontela, S., Muller, H. F. & Friesen, H. G. (1976) Effect of acute and chronic neuroleptic therapy on serum prolactin levels in men and women of different age groups. Clinical Endocrinology, 5, 273–82.CrossRefGoogle Scholar
Feighner, J. P., Robins, E., Guze, S. B., Woodruff, R. A., Winokur, G. & Munoz, R. (1972) Diagnostic criteria for use in research. Archives of General Psychiatry, 26, 57—63.Google Scholar
Gruen, P. H., Sachar, E. J., Langer, G., Altman, N., Leifer, M., Frantz, A. & Halpern, F. S. (1978) Prolactin responses to neuroleptics in normal and schizophrenic subjects. Archives of General Psychiatry, 35, 108–16.Google Scholar
Hanssen, T., Heyden, T., Sundberg, I., Alfredsson, G., Nybäck, H. & Wetterberg, L. (1980) Propranolol in schizophrenia. Archives of General Psychiatry, 37, 685–90.CrossRefGoogle ScholarPubMed
Honigfeld, G., Gillis, R. D. & Klett, C. J. (1966) NOSIE—30: A treatment-sensitive ward behaviour scale. Psychological Reports, 19, 180–2.CrossRefGoogle Scholar
Kolakowska, T., Wiles, D. H., Gelder, M. G. & McNeilly, A. S. (1976) Clinical significance of plasma chlorpromazine levels II: Plasma levels of the drug, some of its metabolites and prolactin in patients receiving long-term phenothiazine treatment. Psychopharmacology, 49, 101–7.Google Scholar
Langer, G., Sachar, E. J., Gruen, P. H. & Halpern, F. S. (1977) Human prolactin responses to neuroleptic drugs correlate with anti-schizophrenic potency. Nature, 266, 639–40.Google Scholar
Lindström, L. H. & Persson, E. (1980) Propranolol in chronic schizophrenia: a controlled study in neuroleptic-treated patients. British Journal of Psychiatry, 137, 126–30.Google Scholar
Mackay, A. V. P., Healey, A. F. & Baker, J. (1974) The relationship of plasma chlorpromazine to its 7-hydroxy and sulphoxide metabolites in a large population of chronic schizophrenics. British Journal of Clinical Pharmacology, 1, 425–30.Google Scholar
McAinsh, J., Baber, N. S., Smith, R. & Young, J. (1978) Pharmacokinetic and pharmacodynamic studies with long-acting propranolol. British Journal of Clinical Pharmacology, 6, 115–21.Google Scholar
McNeilly, A. S. & Hagan, C. (1974) Prolactin, TSH, LH and FSH response to a combined LHRH/TRH test at different stages of the menstrual cycle. Clinical Endocrinology, 3, 427–35.Google Scholar
Meltzer, H. Y., Goode, D. J. & Fang, V. S. (1977) Effects of chlorpromazine on plasma prolactin and chlorpromazine levels. Psychopharmacology Bulletin, 13, 59—60.Google Scholar
Middlemiss, D., Blakeborough, L. & Leather, S. R. (1977) Direct evidence for an interaction of β-adrenergic blockers with the 5HT receptor. Nature, 267, 289–90.Google Scholar
Naber, D., Finkbeiner, C., Fischer, B., Zander, K.-J. & Ackenheil, M. (1980) Effect of long-term neuroleptic treatment on prolactin and norepinephrine levels in serum of chronic schizophrenics: relations to psycho-pathology and extrapyramidal symptoms. Nturopsychobiology, 6, 181–9.Google Scholar
Nikitopoulou, G., Thorner, M., Crammer, J. & Lader, M. (1976) Prolactin and psychophysiologic measures after single doses of thioridazine. Clinical Pharmacology and Therapeutics, 21, 422–9.Google Scholar
Overall, J. E. & Gorham, D. R. (1962) The brief psychiatric rating scale. Psychological Reports, 10, 799—812.Google Scholar
Peet, M., Middlemiss, D. N. & Yates, R. A. (1980) Pharmacokinetic interaction between propranolol and chlorpromazine in schizophrenic patients. Lancet, ii, 978.Google Scholar
Peet, M., Bethell, M. S., Coates, A., Khamnee, A. K., Hall, P., Cooper, S. J., Kino, D. J. & Yates, R. A. (1981) Propranolol in schizophrenia. I. Comparison of propranolol, chlorpromazine and placebo. British Journal of Psychiatry, 139, 105–11.Google Scholar
Phillipson, O. T., McKeown, J. M., Baker, J. & Healey, A. F. (1977) Correlation between plasma chlorpromazine and its metabolites and clinical ratings in patients with acute relapse of schizophrenic and paranoid psychosis. British Journal of Psychiatry, 131, 172–84.Google Scholar
Prien, R. F. & Cole, J. O. (1968) High dose chlorpromazine therapy in chronic schizophrenia. Archives of General Psychiatry, 18, 482–95.Google Scholar
Rivera-Calimlim, L., Nasrallah, H., Strauss, J. & Lasagna, L. (1976) Clinical response and plasma levels: Effect of dose, dosage schedules and drug interactions on plasma chlorpromazine levels. American Journal of Psychiatry, 133, 646–52.Google Scholar
Sakalis, G., Curry, S. H., Mould, G. P. & Lader, M. H. (1972) Physiologic and clinical effects of chlorpromazine and their relationship to plasma level. Clinical Pharmacology and Therapeutics, 13, 931–45.Google Scholar
Sakalis, G., Chan, T. L., Gershon, S. & Park, S. (1973) The possible role of metabolites in therapeutic response to chlorpromazine treatment Psychopharmacologia, 32, 279–84.Google Scholar
Tune, L. E., Creese, I., Depaulo, J. R., Slavney, P. R., Coyle, J. T. & Snyder, S. H. (1980) Clinical state and serum neuroleptic levels measured by radioreceptor assay in schizophrenia. American Journal of Psychiatry, 137, 187–90.Google Scholar
Usdin, E. (1971) The assay of chlorpromazine and metabolites in blood, urine and other tissues. C.R.C. Critical Review of Clinical and Laboratory Science, 2, 347–91.Google Scholar
Vestal, R. E., Kornhauser, D. M., Hollingfield, J. W. & Shand, D. G. (1979) Inhibition of propranolol metabolism by chlorpromazine. Clinical Pharmacology and Therapeutics, 25, 19—24.Google Scholar
Wiles, D. H., Kolakowska, T., McNeilly, A. S., Mandelbrote, B. M. & Gelder, M. G. (1976) Clinical significance of plasma chlorpromazine levels I: Plasma levels of the drug, some of its metabolites and prolactin during acute treatment Psychological Medicine, 6, 407–15.CrossRefGoogle ScholarPubMed
Wilson, R. G., Hamilton, J. R., Boyd, W. D., Forrest, A. P. M., Cole, E. N., Boyns, A. R. & Griffiths, K. (1975) The effect of long-term phenothiazine therapy on plasma prolactin. British Journal of Psychiatry, 127, 71–4.Google Scholar
Wilson, J. D., King, D. J. & Sheridan, B. (1979) Plasma prolactin levels before and during propranolol treatment in. chronic schizophrenia. British Journal of Clinical Pharmacology, 7, 313–4.Google Scholar
Yorkston, N. J., Zaki, S. A., Malik, M. K. U., Morrison, R. C. & Havard, C. W. H. (1974) Propranolol in the control of schizophrenic symptoms. British Medical Journal, iv, 633–5.Google Scholar
Yorkston, N. J., Zaki, S. A., Pitcher, D. R., Gruzelier, J. H., Hollander, D. & Sargeant, H. G. S. (1977) Propranolol as an adjunct to the treatment of schizophrenia. Lancet, ii, 575–8.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.