Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-05T05:02:34.420Z Has data issue: false hasContentIssue false

The Effects of Phenothiazines on Endocrine Function: I

Patients with Inappropriate Lactation and Amenorrhoea

Published online by Cambridge University Press:  29 January 2018

P. J. V. Beumont
Affiliation:
Littlemore Hospital
M. G. Gelder
Affiliation:
Littlemore Hospital
H. G. Friesen
Affiliation:
Royal Victoria Hospital Montreal; now at Dept. of Physiology, University of Manitoba, Winnipeg, Canada
G. W. Harris
Affiliation:
Department of Human Anatomy, University of Oxford
P. C. B. MacKinnon
Affiliation:
Department of Human Anatomy, University of Oxford
B. M. Mandelbrote
Affiliation:
Littlemore Hospital
D. W. Wiles
Affiliation:
Department of Psychiatry, University of Oxford, The Warneford Hospital, Oxford OX3 7JX

Extract

Shortly after the advent of modern psychopharmacological agents in the 1950s it was noted that their clinical use led occasionally to galactorrhoea (Gäde and Heinrich, 1955; Winnik and Tennenbaum, 1955), to menstrual disorders (Polishuk and Kulcsar, 1956), and to false positive pregnancy tests (Foxworth and Lehman, 1957; Marks and Shackcloth, 1966). The drugs were also shown to have a profound effect upon the oestrous cycle (Cranston and Segal, 1960) and breast activity (Sulman and Winnik, 1956; Sulman, 1970) of laboratory animals. Most published reports incriminated the phenothiazines, especially chlorpromazine, and the literature pertaining to this drug was reviewed in detail by De Wied (1967); but similar effects have been noted with several related psychotropic substances (Shader and Di Mascio, 1970). These side effects are generally accepted to result mainly from the action of the drugs on the hypothalamus (De Wied, 1967), but the precise mechanisms involved are not fully understood.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1974 

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

Abraham, G. E. (1969). ‘Solid phase radioimmunoassay of plasma estradiol 17β.’ Journal of Clinical Endocrinology, 29, 866–71.CrossRefGoogle Scholar
Apostolakis, M., Kapetanakis, S., Lazos, G., and Madena-Pyrgaki, A. (1972). ‘Plasma prolactin activity in patients with galactorrhoea after treatment with psychotropic drugs’, in Lactogenic Hormones (eds. Wolstenholme, G. E. W., and Knight, J.), pp. 349–54. Edinburgh and London: Churchill Livingstone.Google Scholar
Arrata, W. S. M., and Alvarez, R. R. de (1972). ‘The oversuppression syndrome.’ American Journal of Obstetrics and Gynaecology, 112, 1025–30.Google Scholar
Beumont, P. J. V., Harris, G. W., Carr, P. J., Friesen, H. G., Kolakowska, T., MacKinnon, P. C. B., Mandelbrote, B. M., and Wiles, D. (1972). ‘Some endocrine effects of phenothiazines: a preliminary report.’ Journal of Psychosomatic Research, 16, 297304.CrossRefGoogle ScholarPubMed
Corker, C. S., Exley, D., and Naftolin, F. (1970). ‘Assay of 17 β-oestradiol by competitive protein binding methods.’ Acta Endocrinologica (Copenhagen), Supplement 147, 305–16.Google Scholar
Cranston, E. M., and Segal, M. S. (1958). ‘Effect of tranquillizers and other agents on the sexual cycle of mice.’ Proceedings of the Society for Experimental Biology and Medicine, 98, 320–22.Google ScholarPubMed
De Wied, D. (1967). ‘Chlorpromazine and endocrine function.’ Pharmacological Reviews, 19, 251–88.Google Scholar
Foxworth, D. L., and Lehman, R. M. (1957). ‘False-positive frog tests due to promazine hydrochloride (Sparine).’ Obstetrics and Gynaecology, 10, 385–7.Google Scholar
Frantz, A. G., Kleinberg, D. L., and Noel, G. L. (1972). ‘Physiological and pathological secretion of human prolactin studied by invitro bioassay’, in Lactogenic Hormones (eds. Wolstenholme, G. E. W., and Knight, J.)., pp. 137–50. Edinburgh and London: Churchill Livingstone.Google Scholar
Friesen, H. G., Guyda, H., Hwang, P., Tyson, J. E., and Barbeau, A. (1972). ‘Functional evaluation of prolactin secretion: a guide to therapy.’ Journal of Clinical Investigation, 51, 706–9.CrossRefGoogle ScholarPubMed
Gäde, E. B., and Heinrich, K. (1955). ‘Klinische Beobachtungen bei Megaphenbehandlung in der Psychiatrie.’ Nervenarzt, 26, 4954.Google Scholar
Gregory, B. A. J. C. (1957). ‘The menstrual cycle and its disorders in psychiatric patients.’ Journal of Psychosomatic Research, 2, 199224.Google Scholar
Hökfelt, T., and Fuxe, F. (1972). ‘On the morphology and the neuroendocrine role of the hypothalamic catecholamine neurone’, in Brain-Endocrine Interaction. Median Eminence: Structure and Function (eds. Knigge, K. H., Scott, D. E., and Weindl, A.), Basel: Karger.Google Scholar
Hotchkiss, J., Atkinson, L. E., and Knobil, E. (1971). ‘Time course of serum oestrogen and luteinizing hormone concentrations during the menstrual cycle of the rhesus monkey.’ Endocrinology, 89, 177–83.Google Scholar
Hwang, P., Guyda, H., and Friesen, H. (1971). ‘Radioimmunoassay of human prolactin.’ Proceedings of the National Academy of Science, 68, 1902–6.CrossRefGoogle ScholarPubMed
Jonhasson, E. D. B. (1969). ‘Progesterone levels in peripheral plasma during the luteal phase of the normal human menstrual cycle measured by a rapid competitive protein binding technique.’ Acta Endocrinologica (Copenhagen), 61, 592606.Google Scholar
Kleinberg, D. L., Wharton, R. N., and Frantz, A. G. (1971). ‘Rapid release of prolactin in normal adults following chlorpromazine stimulation.’ 53rd Programme of Endocrine Society Meetings, San MFrancisco, p. 126.Google Scholar
Levine, H. V., Bergenstall, D. M., and Thomas, L. B. (1962). ‘Persistent lactation: endocrine and histologic studies in 5 cases.’ American Journal of Medical Science, 243, 6473.Google Scholar
Marks, V., and Shackcloth, P. (1966). ‘Diagnostic pregnancy tests in patients treated with tranquillizers.’ British Medical Journal, i, 517–9.Google Scholar
Meites, J., and Nicoll, C. S. (1966). ‘Adenohypophysis: prolactin.’ Annual Review of Physiology, 28, 5788.CrossRefGoogle ScholarPubMed
Midgley, A. R. (1966). ‘Radioimmunoassay: a method for human chorionic gonadotrophin and human luteinizing hormone.’ Endocrinology, 79, 1018.Google Scholar
Midgley, A. R., and Jaffe, R. B. (1968). ‘Regulation of human gonadotrophins: IV. Correlation of serum concentrations of follicle-stimulating and luteinizing hormones during the menstrual cycle.’ Journal of Clinical Endocrinology and Metabolism, 28, 1699–703.CrossRefGoogle ScholarPubMed
Plante, N., and Roy, P. (1967). ‘Galactorrhoea and neuroleptics.’ Laval Médical, 38, 103–7.Google Scholar
Polishuk, W. Z., and Kulcsar, S. (1956). ‘Effects of chlorpromazine on pituitary function.’ Journal of Clinical Endocrinology, 16, 293–3.CrossRefGoogle ScholarPubMed
Ripley, H. S., and Papanicolaou, G. N. (1942). ‘The menstrual cycle with vaginal smear studies in schizophrenia, depression and elation.’ American Journal of Psychiatry, 98, 567–73.CrossRefGoogle Scholar
Rives, O. P., and Rosier, Y. (1959). ‘The frequent occurrence of galactorrhoea during prolonged treatment with phenothiazines.’ Entretiens Franco-allemands de Thérapeutique Psychiatrique, p. 177–8. Lyon.Google Scholar
Robinson, B. (1957). ‘Breast changes in the male and female with chlorpromazine or reserpine therapy.’ Medical Journal of Australia, 44, 239–41.Google ScholarPubMed
Shader, R. I., and Di Mascio, A. (1970). Psychotropic Drug Side-Effects. Baltimore: Williams and Wilkins.Google Scholar
Shearman, R. P., and Turtle, J. R. (1970). ‘Secondary amenorrhea with inappropriate lactation.’ American Journal of Obstetrics and Gynaecology, 106, 818–27.Google Scholar
Spellacy, W. N. (1972). ‘Psychotropic drugs and galactorrhoea: discussion’, in Lactogenic Hormones (eds. Wolstenholme, G. E. W., and Knight, J.), pp. 354–5. Edinburgh and London: Churchill and Livingstone.Google Scholar
Sulman, F. G. (1970). Hypothalamic Control of Lactation. London: William Heineman.Google Scholar
Sulman, F. G. and Winnik, H. Z. (1956). ‘Hormonal effects of chlorpromazine.’ Lancet, i, 161–2.Google Scholar
Tindall, J. S. (1960). ‘A breed difference in the lactogenic response of the rabbit to reserpine.’ Journal of Endocrinology, 20, 7881.Google Scholar
Turkington, R. W. (1972). ‘Measurement of prolactin activity in human serum by the induction of specific milk proteins in vitro: results in various clinical disorders’, in Lactogenic Hormones (eds. Wolstenholme, G. E. W., and Knight, J.), pp. 169–84. Edinburgh and London: Churchill Livingstone.Google Scholar
Winnik, H. Z., and Tennenbaum, L. (1955). ‘Apparition de galactorrhée au cours de traitement de largactil.’ La Presse Médicale, 63, 1092.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.