Abstract
Low chloropromazine (CPZ) levels have been measured in chronically treated schizophrenics. We tested six such patients to determine whether a 2-week CPZ-free period (drug holiday) would improve plasma CPZ levels. We also monitored psychiatric symptoms, autonomic function, and extrapyramidal signs. We found these patients to have low predose CPZ levels that did not change appreciably after the drug holiday. Peak levels following the holiday averaged 28 ±7 ng/ml higher than those measured prior to the holiday. Drug holidays are safe and should be examined more thoroughly as a means of improving plasma neuroleptic levels in chronically treated schizophrenics.
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References
Brooks GW (1959) Withdrawal from neuroleptic drugs. Am J Psychiatry 115:931–932
Committee on Nomenclature and Statistics of the American Psychiatric Association (1968) Diagnostic and statistical manual of mental disorders. II
Curry SH (1968) Determination of nanogram quantities of chloropromazine and some of its metabolites in plasma, using gas-liquid cromatography with an electron capture detector. Anal Chem 40:1251–1255
Curry SH, Marshall JH, Davies JM, Janowsky DS (1970) Chlorpromazine plasma levels and effects. Arch Gen Psychiatry 22:289–296
Dahl SG, Strandjord RE (1977) Pharmacokinetics of chlorpromazine after single and chronic dosage. Clin Pharmacol Ther 21:327–448
Denber H, Bird EG (1955) Chlorpromazine in the treatment of mental illness. Side effects and relapse rates. Am J Psychiatry 112:465–468
Gardos G, Cole JO, Tarsy D (1978) Withdrawal syndromes associated with antipsychotic drugs. Am J Psychiatry 135:1321–1324
Hershon HI, Kennedy PF, McGuire RJ (1972) Persistence of extrapyramidal disorders and psychiatric relapse after withdrawal of long-term phenothiazine therapy. Br J Psychiatry 120:41–50
Jacobs JW, Bernhard MR, Delgado A, Strain JJ (1977) Screening for organic mental syndromes in the medically ill. Ann Intern Med 86:40–46
Lacoursiere RB, Spon HE, Thompson K (1976) Medical effects of abrupt neuroleptic withdrawal. Comp Psychiatry 17:285–294
Overall JE, Hollister LE, Pichot P (1967) Major psychiatric disorders. Arch Gen Psychiatry 16:146–151
Phillipson OT, McKeown JM, Baker J, Healey AF (1977) Correlation between plasma chlorpromazine and its metabolites and clinical ratings in patients with acute relapse of schizophrenic and paranoid psychosis. Br J Psychiatry 131:172–184
Prien RI, Cole JO, Belkin NT (1968) Relapse in chronic schizophrenics following abrupt withdrawal of tranquilizing medication. Br. J Psychiatry 115:679–686
Rivera-Calimlim L, Casaneda L, Lasagna L (1973) Effects of mode of management on plasma chlorpromazine in psychiatric patients. Clin Pharmacol Ther 14:978–986
Rivera-Calimlim L, Gift T, Nasrallah HA, Wyatt RJ, Lasagna (1978) Low plasma levels of CPZ in patients chronically treated with neuroleptics. Commun Psychopharmacol 2:113–121
Rivera-Calimlim L, Nasrallah HA, Strauss J, Lasagna L (1976) Clinical response and plasma levels. Am J Psychiatry 133:646–652
Sakalis G, Curry SH, Mould GP, Lader MH (1972) Physiologic and clinical effects of chlorpromazine and their relationship to plasma level. Clin Pharmacol Ther 13:931–946
Smith RC, Crayton J, Dekirmenjian H, Klass D, Davis JM (1979) Blood levels of neuroleptic drugs in nonresponding chronic schizophrenic patients. Arch Gen Psychiatry 36:579–584
Wode-Helgodt G, Borg S, Tyro B, Sedvall G (1978) Clinical effects and drug concentrations in plasma and cerebrospinal fluid in psychotic patients treated with fixed doses of chlorpromazine. Acta Psychiatr Scand 58:149–173
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Hershey, L.A., Gift, T., Atkins, R.W. et al. Effect of a drug holiday on plasma chlorpromazine levels in chronic schizophrenic patients. Psychopharmacology 73, 355–358 (1981). https://doi.org/10.1007/BF00426465
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DOI: https://doi.org/10.1007/BF00426465