Complications of Chlorpromazine Therapy in 800 Mental-Hospital Patients

Lomas, J.; Boardman, R.H.; Markowe, Morris

doi:10.1016/s0140-6736(55)90642-5

Cited by 71 publications

(19 citation statements)

References 15 publications

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“…Clozapine and olanzapine are the second-generation antipsychotics most frequently associated with seizures, while risperidone appears to have a relatively low seizure induction risk [9]. Previous reports indicated that, among the conventional APs, the clinical incidence of seizures during treatment with chlorpromazine was 1.25 % (10/800 patients) [15], whereas haloperidol rarely induces clinical seizure [16]. Furthermore, the clinical incidence of seizures during treatment with atypical APs was 2.89 % (41/1418 patients) for clozapine, 2.34 % (28/1196 patients) for zotepine, 0.88 % (22/2500 patients) for olanzapine, 0.75 % (18/2387 patients) for quetiapine, and 0.35 % (9/2607 patients) for risperidone [3,[7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of the Treatment of Chronic Antipsychotic Drugs on Epileptic Susceptibility in Genetically Epilepsy-prone Rats

et al. 2015

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Antipsychotic drugs (APs) are of great benefit in several psychiatric disorders, but they can be associated with various adverse effects, including seizures. To investigate the effects of chronic antipsychotic treatment on seizure susceptibility in genetically epilepsy-prone rats, some APs were administered for 7 weeks, and seizure susceptibility (audiogenic seizures) was evaluated once a week during treatment and for 5 weeks after drug withdrawal. Furthermore, acute and subchronic (5-day treatment) effects were also measured. Rats received haloperidol (0.2-1.0 mg/kg), clozapine (1-5 mg/kg), risperidone (0.03-0.50 mg/kg), quetiapine (2-10 mg/kg), aripriprazole (0.2-1.0 mg/kg), and olanzapine (0.13-0.66 mg/kg), and tested according to treatment duration. Acute administration of APs had no effect on seizures, whereas, after regular treatment, aripiprazole reduced seizure severity; haloperidol had no effects and all other APs increased seizure severity. In chronically treated rats, clozapine showed the most marked proconvulsant effects, followed by risperidone and olanzapine. Quetiapine and haloperidol had only modest effects, and aripiprazole was anticonvulsant. Finally, the proconvulsant effects lasted at least 2-3 weeks after treatment suspension; for aripiprazole, a proconvulsant rebound effect was observed. Taken together, these results indicate and confirm that APs might have the potential to increase the severity of audiogenic seizures but that aripiprazole may exert anticonvulsant effects. The use of APs in patients, particularly in patients with epilepsy, should be monitored for seizure occurrence, including during the time after cessation of therapy. Further studies will determine whether aripiprazole really has a potential as an anticonvulsant drug and might also be clinically relevant for epileptic patients with psychiatric comorbidities.

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Section: Introductionmentioning

confidence: 99%

Comparative Analysis of the Treatment of Chronic Antipsychotic Drugs on Epileptic Susceptibility in Genetically Epilepsy-prone Rats

et al. 2015

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“…Urinary incontinence and enuresis associated with alpha-adrenergic blockade causes urinary sphincter relaxation in anatomically predisposed patients (1). The absence of other systemic hypo adrenergic effects such as hypertension shows that alpha-adrenergic blockade cannot accurately explain urinary incontinence.…”

Section: Discussionmentioning

confidence: 99%

“…Urinary incontinence is a rare side effect of quetiapine with potentially adverse impacts on the efficacy of treatment. The first appearance of chlorpromazine-induced Urinary Incontinence (UI) in psychiatry literature dates back to 1955 (1). In 1979, Nurnberg and Ambrosini reported several cases of UI in patients taking phenothiazines and haloperidol (2).…”

Section: Introductionmentioning

confidence: 99%

Quetiapine-Induced Enuresis: Two Case Reports

Elyasi

Darzi

2017

Iran J Psychiatry Behav Sci

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Quetiapine is an effective and well-tolerated atypical dibenzothiazepine antipsychotic with higher affinity for 5-hydroxytryptophan than D2 dopamine receptors. It is a generally well-tolerated drug, yet, is remotely associated with urinary incontinence. Urinary incontinence is an embarrassing and distressing side effect of antipsychotic drugs. This paper reports on 2 patients with bipolar disorder, who developed urinary incontinence after treatment with quetiapine, and suggests dose reduction as the proper method for addressing this side effect. Nocturnal enuresis should be enquired through direct yet sensitive questions. The inevitable corollary is that patients treated with quetiapine should be properly monitored for nocturnal enuresis. A proper response to this side effect does not necessarily cease the antipsychotic medication.

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“…There is, however, no doubt that in patients with a history of seizures or in patients known to have organic brain damage (for example leukotomy), neuroleptics, especially at high doses, increase the fre quency of seizures [1,3,4,10,25,27,28]. In analogy to our rat model, patients with 'petit mal epilepsy' experi ence a prolongation of their 'petit mal status' after treat ment with chlorpromazine [25], However, the following important questions still await an answer: -Is the spike and wave activity in the pharmaco-EEG of patients with psychopharmacological treatment part of the therapeutic effect of the drug?…”

Section: Discussionmentioning

confidence: 99%

Spontaneous EEG Paroxysms in the Rat: Effects of Psychotropic and Alpha-Adrenergic Agents

Kleinlogel¹

1985

Neuropsychobiology

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Approximately 20% of Charles River rats which were chronically implanted with brain electrodes for EEG recordings exhibited within half a year of the implantation spontaneous, paroxysmally occurring, steep EEG potentials of high amplitude (spikes and waves) whilst falling asleep. These EEG paroxysms were dose dependently antagonized by the ‘petit mal drugs dipropylacetate, ethosuximide and trimethadione as well as by the anticonvulsant drugs diazepam and nitrazepam. The neuroleptics chlorpromazine, haloperidol and thioridazine prolonged the EEG paroxysms. The α₁-adrenoceptor antagonist prazosin and the α₂-adrenoceptor agonists guanfacine and clonidine prolonged, whereas the α₂-adrenoceptor antagonist yohimbine shortened, the EEG paroxysms. The effect of guanfacine was antagonized by yohimbine. The convulsant drugs bicuculhne, 3-mercaptopropionic acid and pentetrazol had only a slight influence on the EEG paroxysms. The results are discussed with respect to the anti- and proconvulsant and convulsant activity of psychotropic drugs and their underlying mechanisms of action, particularly with regard to their interaction with central α-adrenergic mechanisms.

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Complications of Chlorpromazine Therapy in 800 Mental-Hospital Patients

Cited by 71 publications

References 15 publications

Comparative Analysis of the Treatment of Chronic Antipsychotic Drugs on Epileptic Susceptibility in Genetically Epilepsy-prone Rats

Comparative Analysis of the Treatment of Chronic Antipsychotic Drugs on Epileptic Susceptibility in Genetically Epilepsy-prone Rats

Quetiapine-Induced Enuresis: Two Case Reports

Spontaneous EEG Paroxysms in the Rat: Effects of Psychotropic and Alpha-Adrenergic Agents

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