Predictive indices for chlorpromazine therapy in schizophrenics.

Abstract

1 Response to chlorpromazine therapy was studied in 24 schizophrenics and 75% reduction in Brief Psychiatric Rating Scale (BPRS) within 4 weeks of treatment was taken to indicate good response. 2 Test oral dose of CPZ (200 mg) was administered and serial blood samples and total urine excreted in 6 h were taken for analyses of CPZ and its metabolites. 3 Area under the plasma time curve (AUC) showed an inverted U-shaped relationship with % reduction in BPRS. 4 Three groups of patients were identified, responders, l-and h-group non-responders. 5 1-and h-groups respond on further treatment with haloperidol (30 mg daily) and ECT respectively. 6 Responders showed threshold metabolic molar fraction MMFHO_CPZ ' 3.0 x 10 -and MMFHo-cPz/ MMFcpz-so . 1.

Effect of Drug Pretreatment on the Metabolic Oxidation of Chlorpromazine in Rat

“…Therefore, chloroquine could be of immense importance to the clini cian in treating schizophrenics where low plasma CPZ and CPZ-OH levels appear to be responsible for non-therapeutic response [Dixon et al" 1982]. Unfortunately long-term antimalarial treatment tends to be associated with high toxicity [Rollo, 1980],…”

“…7-hydroxychlorpromazine (CPZ-OH) and CPZ sulfoxide (CPZ-SO), has generated much interest with respect to its significance in schizophrenia. Schizophrenics who respond to CPZ therapy appear to have higher plasma CPZ-OH con centrations than nonresponders [Sakalis et al, 1973;Mackay ex al., 1974;Sakaurai et al, 1980], and this differential is also main tained in their pattern of urinary excretion of metabolites [Dixon et al, 1982].…”