A New and Unusual Reaction to Chlorpromazine

Zelickson, Alvin S.; Zeller, Hector C.

doi:10.1001/jama.1964.03060300056018

Cited by 84 publications

(20 citation statements)

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“…Because of this effect, chlorpromazine is rarely used in equine medicine today [30]. Animals in treatment with chlorpromazine should not be exposed to sun because it may induce phototoxic reactions [45, 46]. …”

Section: Synthetic Galactogoguesmentioning

confidence: 99%

Pharmacological Overview of Galactogogues

Penagos-Tabares

Jaramillo

Ruiz-Cortés

2014

Veterinary Medicine International

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Galactogogues are substances used to induce, maintain, and increase milk production, both in human clinical conditions (like noninfectious agalactias and hypogalactias) and in massification of production in the animal dairy industry. This paper aims to report the state of the art on the possible mechanisms of action, effectiveness, and side effects of galactogogues, including potential uses in veterinary and human medicine. The knowledge gaps in veterinary clinical practice use of galactogogues, especially in the standardization of the lactogenic dose in some pure drugs and herbal preparations, are reviewed.

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Section: Synthetic Galactogoguesmentioning

confidence: 99%

Pharmacological Overview of Galactogogues

Penagos-Tabares

Jaramillo

Ruiz-Cortés

2014

Veterinary Medicine International

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“…However, chlorpromazine and several other related phenothiazines are known to cause both phototoxic and photoallergic reactions in patients receiving low doses of these drugs (4-6). High dosage and prolonged treatment can produce severe dermatitis that is frequently accompanied by darkening of the skin due to the deposition of melanin in lower layers of the dermis (5). Such patients may also suffer retinal damage, ocular opacity and loss of vision.…”

Section: Introductionmentioning

confidence: 99%

Photoinduced Free Radicals from Chlorpromazine and Related Phenothiazines: Relationship to Phenothiazine-Induced Photosensitization

Chignell¹,

Motten²,

Buettner³

1985

Environmental Health Perspectives

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JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.. The National Institute of Environmental Health Sciences (NIEHS) and Brogan & Partners are collaborating with JSTOR to digitize, preserve and extend access to Environmental Health Perspectives.Chlorpromazine and several other related phenothiazines are known to cause both phototoxic and photoallergic reactions in the skin and eyes of patients receiving these drugs. While the detailed mechanisms of photosensitization are not known, it is obvious that the first step must be the absorption of light by the drug, its metabolites, or photoproducts, or possibly an induced endogenous chemical. In this review, the free-radical photochemistry of phenothiazines is described, and the evidence for the involvement of photoinduced free radicals in photosensitization is examined. Upon irradiation chlorpromazine yields a variety of free radicals including the corresponding cation radical (via photoionization), the neutral promazinyl radical and a chlorine atom (CI') (via homolytic cleavage), and a sulfur-centered peroxy radical. The chlorpromazine cation radical is probably responsible for some of the observed in vitro phototoxic effects of this drug. However, it seems unlikely that the cation radical is involved in phototoxicity in vivo, since photoionization only occurs when chlorpromazine is excited into the S2 level (x,, < 280 nm). The promazinyl radical is a more likely candidate for the phototoxic species both in vivo and in vitro. In addition, this radical can react covalently with proteins and other macromolecules to yield antigens which could be responsible for the photoallergic response to chlorpromazine. Neither oxygen-derived radicals nor singlet oxygen (102*), appear to be important in chlorpromazine photosensitization. In contrast, it would seem that promazine-induced phototoxicity may result in part from the generation of superoxide (02').The inability of promazine, which lacks a chlorine atom at the 2-position, to undergo homolytic fission to give the promazinyl radical, probably explains why this drug is much less phototoxic than chlorpromazine both in vivo and in vitro.

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“…There have been five reports of retinopathy on doses never exceeding 1000 mg/day. Two of these patients had also received chlorpromazine 7,8 , which may also cause a pigmentary retinopathy 4,9 , and had been on thioridazine for at least 7 months. The other three cases had all been on thioridazine for between 13 and 17 years 10−12 .…”

Section: Discussionmentioning

confidence: 99%