Immunologic and Coagulation Disorders in Chlorpromazine-Treated Patients

Abstract

The prevalence of immunologic and coagulation disorders in 75 schizophrenic patients treated with chlorpromazine or other antipsychotic drugs was evaluated. Four groups were studied: Group A, chlorpromazine treatment for more than 2 1/2 years; Group B, chlorpromazine and other antipsychotic drug treatment for more than 2 1/2 years; Group C, chlorpromazine treatment for less than 2 1/2 years; Group D, no chlorpromazine, but other antipsychotic drug treatment. Significant elevation of serum IgM and prolongation of partial thromboplastin time were noted in patients who had long-term chlorpromazine treatment. The latter was caused by a circulating inhibitor resembling that seen with systemic lupus erythematosus. There was a significant correlation between the IgM level versus chlorpromazine dose or duration of treatment and the partial thromboplastin time versus chlorpromazine dose or duration of treatment. In Groups A and B, 63% had a positive antinuclear antibody test (greater than or equal to 1:80), 40% had antibodies to native DNA, and 58% had antibodies to nucleoprotein. These antibodies were negative in the other groups. The percentages of T lymphocytes were below normal in 13 of 41 patients treated with chlopromazine. Twenty of 42 patients in Groups A and B, and none of 28 in Groups C and D had splenomegaly. This study indicates that most patients on long-term chlorpromazine treatment develop one or more immunologic abnormalities.

The Complement System in Schizophrenia

“…80,81 Spivak et al 63 found that, in the group of schizophrenic patients who had never received psychotropic medication (n = 20), total hemolytic activity was significantly lower than in healthy controls (n=37). Nevertheless, no statistical differences were observed between haloperidol-treated (n = 34) versus drug-free (n=37) and haloperidol-and never-treated schizophrenic patient groups.…”

Transient lupus anticoagulant and fansidar therapy

“…Appearance of the inhibitor has been associated with a number of drugs, such as penicillin and notably chlorpromazine, where therapy leads to the development of a number of immunological abnormalities (Zarrabi et al, 1979). There is no previous report ofthe lupus anticoagulant with Fansidar administration.…”

Prevalence of antiphospholipid antibodies in psychiatric patients users and non‐users of antipsychotics

“…This suggestion was initially proposed in the 1980's, in response to a high prevalence of aPL antibodies in antipsychotics users (Zarrabi et al, 1979;Canoso & Sise, 1982;Canoso & de Oliveira, 1988;Canoso et al, 1990;Lillicrap et al, 1990;Davis et al, 1994;Kanjolia et al, 1997;Vargas-Alarcon et al, 1997;Schwartz et al, 1998Schwartz et al, , 1999Schwartz et al, , 2009. Then it was speculated that this association could depend on antipsychotics type, asother observational series showed an increase in the prevalence of aPL antibodies in chlorpromazine users compared with users of other antipsychotics (Zarrabi et al, 1979;Canoso & de Oliveira, 1988).…”