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Clinical Significance of Plasma Drug and Prolactin Levels During Acute Chlorpromazine Treatment: A Replication Study

Published online by Cambridge University Press:  29 January 2018

Tamara Kolakowska
Affiliation:
University of Oxford, Department of Psychiatry, Littlemore Hospital Research Unit, Littlemore Hospital, Oxford OX4 4XN
Michael Orr
Affiliation:
University of Oxford, Department of Psychiatry, Littlemore Hospital Research Unit, Littlemore Hospital, Oxford OX4 4XN
Michael Gelder
Affiliation:
University of Oxford, Department of Psychiatry, Littlemore Hospital Research Unit, Littlemore Hospital, Oxford OX4 4XN
Manuela Heggie
Affiliation:
University of Oxford, Department of Psychiatry, Littlemore Hospital Research Unit, Littlemore Hospital, Oxford OX4 4XN
David Wiles
Affiliation:
University of Oxford, Department of Psychiatry, Littlemore Hospital Research Unit, Littlemore Hospital, Oxford OX4 4XN
Michael Franklin
Affiliation:
University of Oxford, Department of Psychiatry, Littlemore Hospital Research Unit, Littlemore Hospital, Oxford OX4 4XN

Summary

Nineteen patients with acute psychoses, the majority schizophrenics, were studied in the course of chlorpromazine (CPZ) treatment. Plasma levels of the drug, plasma prolactin (PRL), extrapyramidal side-effects (EPS) and changes in mental state were monitored weekly, as in our earlier study. The results confirm some of our previous findings: (a) plasma CPZ levels vary widely among patients and correlate poorly with daily doses of CPZ; (b) increased plasma PRL is associated with higher plasma CPZ levels and is more common among the patients who develop EPS; and (c) none of these three variables differ between groups of patients with good and poor treatment outcome. However we did not confirm our previous finding of a significant association between EPS and higher plasma CPZ, nor did we find that the ratio of CPZ-sulphoxide to CPZ differed between the improved patients and the rest.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1979 

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References

Carlsson, A. (1978) Antipsychotic drugs, neurotransmitters and schizophrenia. American Journal of Psychiatry, 135, 164–73.Google Scholar
Curry, S. H. (1968) Determination of nanogram quantities of chlorpromazine and some of its metabolites using gas liquid chromatography with an electron capture detector. Analytical Chemistry, 40, 1251–5.CrossRefGoogle ScholarPubMed
Curry, S. H., Marshall, J. H. L., Davis, S. M. & Janovsky, D. S. (1970) Chlorpromazine plasma levels and effects. Archives of General Psychiatry, 22, 1289–96.Google Scholar
De Rivera, J. L., Lal, S., Ettigi, P., Hontela, S., Muller, F. H. & Friesen, H. G. (1976) Effects of acute and chronic neuroleptic therapy on serum prolactin levels in males and females of different age groups. Clinical Endocrinology, 5, 273–82.CrossRefGoogle 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
Hansen, C. E. & Larsen, N. E. (1974) Perphenazine concentrations in human whole blood—a pilot study during antipsychotic therapy using different administration forms. Psychopharmacologia (Berlin), 37, 31–6.Google ScholarPubMed
Johnstone, E. C., Frith, C. D., Crow, T. J., Carney, M. W. P. & Prise, J. S. (1978) Mechanism of the antipsychotic effect in the treatment of acute schizophrenia. Lancet, i, 848–51.Google Scholar
Lindholm, H., Gullberg, B., Ohman, A. & Sedvall, G. (1978) Effects of perphenazine enanthate injections on prolactin levels in plasma from schizophrenic women and men. Psychopharmacology, 57, 14.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.CrossRefGoogle Scholar
Mathysse, S. W. (1977) The role of dopamine in schizophrenia. In ‘Neuroregulators and Psychiatric Disorders’, (Eds.) Usdin, S., Hamburg, D. A. and Barchas, J. O. New York, Oxford University Press, pp 313.Google Scholar
McNeilly, A. S. & Hagen, C. (1974) Prolactin, TSH, LH and FSH responses to a combined LHRH/TRH test at different stages of the menstrual cycle. Clinical Endocrinology, 3, 427–35.CrossRefGoogle ScholarPubMed
Meltzer, H. Y. & Fang, V. S. (1976) The effect of neuroleptics on serum prolactin in schizophrenic patients. Archives of General Psychiatry, 33, 279–86.Google Scholar
Moore, K. E. & Gudelsky, G. A. (1977) Drug actions on dopamine turnover in the median eminence. In Advances in Biochemical Psychopharmacology (eds. Costa, E. and Gessa, G. L.). Vol. 16. New York: Raven Press. 227–35.Google Scholar
Overall, G. E. & Gorham, D. R. (1962) The brief psychiatric rating scale. Psychological Reports, 10, 799.CrossRefGoogle Scholar
Rivera-Calimlim, L., Cataneda, L. & Lasagna, L. (1974) Effects of mode of management on plasma chlorpromazine in psychiatric patients. Clinical Pharmacology and Therapeutics, 14, 979–85.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 ScholarPubMed
Sachar, E. J. (1978) Neuro-endocrine responses to psychotropic drugs. In Psychopharmacology: A Generation of Progress. (Eds.) Lipton, M. A., DiMascio, A. and Killam, K. F. pp 499507, New York: Raven Press.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, 14, 979–85.Google Scholar
Simpson, G. H. & Angus, J. W. S. (1970) A rating scale for extrapyramidal side-effects. Acta Psychiatrica Scandinavica, Supplement 212, 1119.CrossRefGoogle Scholar
Siris, S. G., Van Kammen, D. P. & De Fraits, E. G. (1978) Serum prolactin and antipsychotic responses to pimozide in schizophrenia. Psychopharmacology Bulletin, 14 (1), 1114.Google Scholar
Spitzer, R. L., Endicott, J., Robins, E., Kuriamsky, J. & Gurland, B. (1975) Preliminary report of the reliability of research diagnostic criteria applied to psychiatric case records. In: Predictability in Psychopharmacology. (Eds.) Sudilovsky, A., Gershon, S. & Beer, B. New York: Raven Press, pp 147.Google Scholar
Stephens, J. H., Astrup, C. H. & Mangram, S. C. (1966) Prognostic factors in recovered and deteriorated schizophrenics. American Journal of Psychiatry, 120, 1116–21.Google Scholar
Van Praag, H. M. (1977) The significance of dopamine for the mode of action of neuroleptics and the pathogenesis of schizophrenia. British Journal of Psychiatry, 130, 463–74.CrossRefGoogle ScholarPubMed
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.Google Scholar
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