Effect of chlorpromazine treatment on prolactin levels in cerebrospinal fluid and plasma of psychotic patients

Abstract

In psychotic patients, levels of prolactin in cerebrospinal fluid (CSF) and plasma were determined by radioimmunoassay before and after 2 and 4 weeks of treatment with chlorpromazine (CPZ). CPZ was given in one of three randomly selected fixed doses: 200, 400 or 600 mg per day. Before treatment, low levels of immunoreactive prolactin-like material (PRL) were found in the CSF of most patients. The concentration in CSF was about 20% of the plasma level. In CSF but not in plasma, the pre-treatment level of PRL was significantly higher in women than in men. During CPZ treatment, the PRL levels in CSF as well as in plasma were significantly elevated in both sexes after 2 as well as 4 weeks. The elevation was significantly greater in women, and was similar at the two time intervals studied. There was a significantly positive relationship between the dose of CPZ and the PRL elevation in both body fluids in both men and women. Before treatment no significant correlation between the PRL levels in CSF and plasma in either sex could be observed. During treatment, there was a significant correlation between the change in PRL levels in CSF and plasma in both men and women. CPZ treatment did not increase the levels of total protein, follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH) or oestradiol-(17-beta) in either the CSF or the plasma.

Prolactin response to zotepine in schizophrenic patients

“…The study shows no evidence of tolerance in the prolactin response to zotepine, in line with fixeddose studies for chlorpromazine (Wode-Helgodt et al, 1977;Alfredsson er al., 1984), sulpiride (Alfredsson er al., 1984), and haloperidol (Linkowski et al, 1984).…”

Prolactin Levels in Cerebrospinal Fluid of Patients with Chronic Schizophrenia

“…They include serotonin, thyrotropin releasing hormone (TRH), histamine, acetyl choline, prostaglandins, GABA, endorphins, encephalins and estrogenic hormones (11,20,30,40,45). The present finding of higher CSF baseline concentrations of PRL in female pa tients is in accordance with the results of W<j>de-Helgodt et al (47), who noted signifi cantly higher CSF PRL pretreatment levels in psychotic women than in equally disturbed male patients. After 2 -4 weeks of chlorpromazine therapy, the authors observed a significantly higher elevation of CSF PRL in female patients than in male patients.…”

“…Corre spondingly, a more sensitive PRL response in women than in men has also been demonstrated by Jones et al (19) after administration of chlomipramine to depressed patients. These findings are suggested to be due to estrogeninduced sensitization of the PRL system to psychopharmacological manipulation (36,47).…”

“…In addition, attempts to correlate the clinical outcome with plasma or CSF PRL response in patients receiv ing antipsychotic medication, have encountered a number of confounding variables, and have failed to produce clear-cut clinical implications (30,47,50). Longer et al (23) maintain, however, that in spite of the existing limita tions, testing the PRL response may be useful in identifying cases of noncompliance or inadequate bioavailability of neuroleptic drugs used in the pharmacotherapy of schizo phrenia.…”

Effect of Long-Term Neuroleptic Treatment on Prolactin and Norepinephrine Levels in Serum of Chronic Schizophrenics: Relations to Psychopathology and Extrapyramidal Symptoms

“…46). During acute neuroleptic treatment, the plasma Prl level has been found to be significantly correlated with the serum levels of neuroleptics (31,51,54), but only within a narrow range as there is a maximal Prl response at low doses of neuroleptics, below the therapeutic range (22,34). Another significant correlation between the potency to release Prl and their antipsycho tic property has been reported (22,33).…”