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Clozapine versus Perphenazine: The Value of the Biochemical Mode of Action of Neuroleptics in Predicting their Therapeutic Activity

Published online by Cambridge University Press:  29 January 2018

H. M. van Praag ,
J. Korf  and
L. C. W. Dols
H. M. van Praag
Affiliation:
Department of Biological Psychiatry, Psychiatric University Clinic, Oostersingel 59, Groningen, The Netherlands
J. Korf
Affiliation:
Department of Biological Psychiatry, Psychiatric University Clinic, Oostersingel 59, Groningen, The Netherlands
L. C. W. Dols
Affiliation:
Department of Biological Psychiatry, Psychiatric University Clinic, Oostersingel 59, Groningen, The Netherlands
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Summary

The chemical structure of a neuroleptic does not reliably predict the exact profile of its therapeutic action. We considered the question whether the biochemical action of a neuroleptic, and specifically the ratio between DA-receptor block and NA-receptor block, might have a higher predictive value in this respect. In this context we carried out a double-blind study of the therapeutic value of clozapine and perphenazine in acute psychoses of varying symptomatology and aetiology. There are strong indications that clozapine has only a slight inhibitory effect on transmission in central DA-ergic neurons, but markedly inhibits transmission in central NA-ergic neurons, and that the reverse applies to perphenazine. In view of these data we expected perphenazine to be a stronger antipsychotic and a weaker sedative than clozapine, and vice versa. The plausibility of this hypothesis was demonstrated. Partly also on the basis of earlier research, we concluded that the biochemical action of a neuroleptic is a more faithful predictor of its therapeutic action profile than the chemical structure.

Type
Papers
Information
The British Journal of Psychiatry , Volume 129 , Issue 6 , December 1976 , pp. 547 - 555
Copyright
Copyright © Royal College of Psychiatrists, 1976 

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