Summary
The effect of melperone on the isolated guinea-pig papillary muscle were compared with those of three other neuroleptics-haloperidol, thioridazine and chlorpromazine. At 10−6 M only melperone prolonged the effective refractory period without reducing contractility. With melperone in the concentration 10−5 M and less, no further changes other than a homogeneous prolongation of the action potential were found.
Haloperidol at 10−6 M caused a prolongation of the action potential, a flattening of the repolarization phase and a 40% decrease in contractile force. At 10−5 M haloperidol reduced the resting potential (RP), the action potential amplitude (AP), the maximum upstroke velocity (MUV) of the action potential and the contractile force.
Thioridazine at 10−6 M reduced MUV and the contractile force. At 10−5 M thioridazine decreased the overshoot and a very pronounced decrease in MUV was registered. A flattening in the repolarization phase was seen from 10−6M.
Chlorpromazine at 10−6 M reduced MUV, contractile force and caused a flattening of the repolarization phase. At 10−5 M chlorpromazine decreased the overshoot and the RP and caused a very pronounced decrease in the MUV.
Thus, melperone differed from the other compounds in the ability to induce homogeneous prolongations of the action potential and the effective refractory period without affecting the contractility. (Antiarrhythmic activity of type III of Vaughan-Williams, 1970.)
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References
Alexander, C. S., Niño, A.: Cardiovascular complications in young patients taking psychotropic drugs. Am. Heart J. 78, 757–769 (1969)
Arita, M., Imanishi, S.: The effects of chlorpromazine on the electrical and mechanical activities of the isolated guinea-pig heart. Jap. Heart J. 11, 391–399 (1970)
Arita, M., Surawicz, B.: Electrophysiologic effects of phenothiazines on canine cardiac fibres. J. Pharmacol. Exp. Ther. 184, 619–630 (1973a)
Arita, M., Surawicz, B.: Electrophysiologic effects of phenothiazines on human atrial fibres. Jap. Heart. J. 14, 398–405 (1973b)
Arora, R. B., Madan, B. R.: Chlorpromazine in experimental cardiac arrhythmias. J. Indian Med. Assoc. 26, 262–264 (1956)
Belpaire, F. M., Vanderheeren, F. A. J., Bogaert, M. G.: Binding of thioridazine and some of its metabolites to human serum protein and human albumin. Arzneimittel-Forsch. 25, 1969–1971 (1975)
Bertolo, L., Novakovic, L., Penna, M.: Antiarrhythmic effects of droperidol. Anesthesiology 37, 529–535 (1972)
Buyze, G., Egberts, P. F. C., Muusze, R. G., Poslavsky, A.: Blood levels of thioridazine and some of its metabolites in psychiatric patients. Psychiat. Neurol. Neurochir. (Amst.) 76, 229–239 (1973)
Carlsson, C., Dencker, S. J., Grimby, G., Häggendahl, J.: Circulatory studies during physical exercise in mentally disordered patients. I. Effects of large doses of chlorpromazine. Acta Med. Scand. 184, 499–509 (1968)
Carlsson, C., Dencker, S. J., Grimby, G., Häggendahl, J., Jonsson, G.: Hemodynamic effects of thiothixene and chlorpromazine in schizophrenic patients at rest and during exercise. Int. J. Clin. Pharmacol. Biopharm. 13, 262–268 (1976)
Carmeliet, E., Vereecke, J.: Adrenaline and the plateau phase of the cardiac action potential. Importance of Ca2+, Na+ and K+ conductance. Pflügers Arch. Ges. Physiol. 313, 300–315 (1969)
Christensen, J. A., Hernestam, S., Lassen, J. B., Sterner, N.: Pharmacological and toxicological studies on γ-(4-methyl-piperidino)-p-fluorobutyrophenone (FG5111) — a new neuroleptic agent. Acta Pharmacol. (Kbh.) 23, 109–132 (1965)
Clementz, B., Grampp, W.: A method for rapid bevelling of micropipette electrodes. Acta Physiol. Scand. 96, 286–288 (1976)
Courvoisier, S., Fournel, J., Ducrot, R., Kolsky, M., Koetschet, P.: Propriétés pharmacodynamiqués du chlorhydrate de chloro-3 (dimethylamino-3-propyl)-10 phenothiazine (4560 R.P.). Arch. Int. Pharmacodyn. 92, 305–361 (1953)
Crane, G. E.: Cardiac toxicity and psychotropic drugs. Dis. Nerv. Syst. 31, 534–539 (1970)
Curry, S. H.: Plasma protein binding of chlorpromazine. J. Pharm. Pharmacol. 22, 193–197 (1970)
Dahl, S. G., Refsum, H.: Effects of levomepromazine, chlorpromazine and their sulfoxides on isolated rat atria. Eur. J. Pharmacol. 37, 241–248 (1976)
Dahl, S. G., Strandjord, R. E.: Pharmacokinetics of chlorpromazine after single and chronic dosage. Clin. Pharmacol. Ther. 21, 437–448 (1977)
Di Palma J. R., Catenacci, A. J.: Chlorpromazine protection against hydrocarbon-epinephrine induced ventricular arrhythmia. Fed. Proc. 14, 333 (1955)
Forsman, A., Martensson, E., Nyberg, G., Öhman, R.: A gas chromatographic method for determining haloperidol. Naunyn-Schmiedeberg's Arch. Pharmacol. 286, 113–124 (1974)
Fowler, N. O., McCall, D., Chou, T.-C., Holmes, J. C., Hanenson, J. B.: Electrocardiographic changes and cardiac arrhythmias in patients receiving psychotropic drugs. Am. J. Cardiol. 37, 223–230 (1976)
Franchiset-Garnier, M.-J.: Modifications electrocardiographiques provoqées par l'amiodarone (Cordarone). Thèse, Université René Descartes (1971)
Freeman, A. R., Spirtes, M. A.: Further effects of chlorpromazine in the human erythrocyte membrane. Biochem. Pharmacol. 12, 1235–1237 (1963)
Giles, T. D., Modlin, R. K.: Death associated with ventricular arrhythmia and thioridazine hydrochloride. J. Am. Med. Assoc. 205, 98–100 (1968)
Holland, W. C.: A possible mechanism of action of quinidine. Am. J. Physiol. 190, 492–494 (1957)
Hollander, P. B., Cain, R. M.: Effects of thioridazine on transmembrane potential and contractile characteristics of guinea-pig hearts. Eur. J. Pharmacol. 16, 129–135 (1971)
Hollister, L. E., Kosek, J. C.: Sudden death during treatment with phenothiazine derivates. J. Am. Med. Ass. 192, 93–96 (1965)
De Jonghe, F. E. R. E. R., van der Helm, H. J.: Plasma concentrations of thioridazine in patients with depression. Acta Psychiat. Scand. 46, 360–364 (1970)
Katz, A. M., Repke, D. J.: Calcium-membrane interactions in the myocardium: Effects of ouabain, epinephrine and 3′,5′-cyclic adenosine monophosphate. Am. J. Cardiol. 31, 193–201 (1973)
Kelly, H. G., Fay, J. E., Laverty, S. G.: Thioridazine hydrochloride (Mellaril): its effect on the electrocardiogram and a report of two fatalities with electrocardiographic abnormalities. Can. Med. Ass. J. 89, 546–554 (1963)
Klein, R. L., Holland, W. C.: Na24 and K42 exchange in atrial fibrillation. Am. J. Physiol. 193, 239–243 (1958)
Klein, R. L., Holland, W. C., Tinsley, B.: Quinidine and unidirectional cation fluxes in atria. Circ. Res. 8, 246–252 (1960)
Kurz, H., Mohr, E.: Der Einfluß von Acidose und Alkalose auf die Bindung von Arzneimitteln a Plasmaproteine. Naunyn-Schmiedeberg's Arch. Pharmacol. 260, 164 (1967)
Landmark, K. H.: Kardiale virkninger av fenothiazinderivater. Nord. Med. 83, 617–648 (1970)
Landmark, K.: The effect of thioridazine and promazine in reducing the potassium loss from isolated perfused rat hearts. Acta Pharmacol. Toxicol. (Kbh.) 29, 49–59 (1971a)
Landmark, K.: The action of promazine and thioridazine in isolated rat atria. 1. Effects on automaticity, mechanical performance, refractoriness and excitability. Eur. J. Pharmacol. 16, 1–7 (1971b)
Landmark, K.: Changes in rat atria action potentials induced by promazine and thioridazine. Acta Pharmacol. Toxicol. (Kbh.) 30, 465–479 (1971c)
Landmark, K.: The action of promazine and thioridazine in isolated rat atria. 2. Effects of varying concentrations of potassium and sodium on automaticity, mechanical performance, refractoriness and excitability. Eur. J. Pharmacol. 17, 113–122 (1972a)
Landmark, K.: The action of promazine and thioridazine in isolated rat atria. 3. Effects of varying concentrations of calcium and different frequencies and strengths of stimulation on contractile force and excitability. Eur. J. Pharmacol. 17, 365–374 (1972b)
Landmark, K.: The mode of action of promazine and thioridazine in isolated rat cardiac muscle. Universitetsforlaget Oslo (1972c)
Landmark, K., Øye, J.: The action of thioridazine and promazine on biological membranes: Relationship between ATP-ase inhibition and membrane stabilization. Acta Pharmacol. Toxicol. (Kbh.) 29, 1–8 (1971)
Landmark, K., Glomstein, A., Øye, J.: The effect of thioridazine and promazine on the isolated contracting rat heart. Acta Pharmacol. Toxicol. (Kbh.) 27, 173–182 (1969)
Landmark, K., Haffner, J. F. W., Setekleiv, J.: Reduction in 42K efflux from rat atria by promazine and thioridazine. Acta Pharmacol. Toxicol. (Kbh.) 31, 54–64 (1972)
Langslet, A.: Changes in coronary flow and ECG in the isolated perfused rat heart induced by phenothiazine drugs. Acta Pharmacol. Toxicol. (Kbh.) 27, 183–192 (1969)
Langslet, A.: ECG-changes induced by phenothiazine drugs in the anaesthetized rat. Acta Pharmacol. Toxicol. (Kbh.) 28, 256–264 (1970a)
Langslet, A.: Membrane stabilization and cardiac effects of d,l-propranolol, d-propranolol and chlorpromazine. Eur. J. Pharmacol. 13, 6–14 (1970b)
Leestma, J. E., Koenig, K. L.: Sudden death and phenothiazines. Arch. Gen. Psychiat. 18, 137–148 (1968)
Lingjaerde, O.: EKG-forandringer, kardiale rytmeforstyrelser og mors subita under fenothiazinbehandling. T. Norske Laegeforen. 87, 90–94 (1967)
Madan, B. R., Pendse, V. K.: Antiarrhythmic activity of thioridazine hydrochloride (Mellaril). Am. J. Cardiol. 11, 78–81 (1963)
March, J. E., Donato, D., Turano, P., Turner, W. J.: Interpatient variation and significance of plasma levels of chlorpromazine in psychotic patients. J. Med. 3, 146–162 (1972)
Melville, K. J.: Observations on the adrenergic-blocking and antifibrillatory actions of chlorpromazine. Fed. Proc. 13, 386–387 (1954)
Melville, K. J.: Studies on the cardiovascular actions of chlorpromazine. I. Antiadrenergic and antifibrillatory actions. Arch. Int. Pharmacodyn. 115, 278–305 (1958)
Mårtensson, E., Roos, B.-E.: Serum levels of thioridazine in psychiatric patients and healthy volunteers. Eur. J. Clin. Pharmacol. 6, 181–186 (1973)
Noble, D., Tsien, R. W.: The repolarization process of heart cells. Electrical phenomena in the heart (De Mello, W. C., eds.), pp. 133–161. New York-London: Academic Press, 1972
Olsson, S. B., Brorson, L., Varauskas, E.: Class 3 antiarrhythmic action in man. Observations from monophasic action potential recordings and amiodarone treatment. Br. Heart J. 35, 1255–1259 (1973)
Ovesen, L., Møgelvang, J. C.: The antiarrhythmic effect of a neuroleptic compound, melperone. Clinical study. 7th Congress of the European Society of Cardiology Amsterdam 20–25 June, 1976
Peele, R., von Loetzen, J. S.: Phenothiazine deaths: a critical review. Am. J. Psychiatry 130, 306–309 (1973)
Petersen, E.: Experimental antiarrhythmic properties of melperone a neuroleptic butyrophenone. Acta Pharmacol. (Kbh.) 42, 245–251 (1978)
Polster, P., Vaughan-Williams, E. M.: The effect of prolonged treatment with oxyfedrine on intracellular potentials and on other features of cardiac function in rabbits and guinea-pigs. Br. J. Pharmacol. 47, 187–195 (1973)
Refsum, H., Passwal, M., Olsson, S.-O.: Antiarrhythmic effects of two neuroleptics, melperone and thioridazine, on isolated rat atria. Acta Pharmacol. Toxicol. (Kbh.) Suppl. 4, 41, 72 (1977)
Reuter, H.: The dependence of slow inward current in Purkinje fibres on the extracellular calcium-concentration. J. Physiol. (Lond.) 192, 479–492 (1967)
Ruggerini, R., Grugni, P., Bolognesi, L.: L'azione antiaritmica del deidrobenzperidolo. Minerva Anaesthesiol. 36, 282–285 (1970)
Seeman, P., Weinstein, J.: Erythrocyte membrane stabilization by tranquilizers and antihistamines. Biochem. Pharmacol. 15, 1737–1752 (1966)
Sharma, P. L., Arora, R. B.: Antiarrhythmic activity of some phenothiazine derivates in experimental cardiac arrhythmias. Indian J. Med. Res. 49, 1099–1112 (1961)
Singh, K. P., Sharma, V. N., Rathore, D. S.: Pharmacological actions of some recently synthesized phenothiazine derivatives. Indian J. Med. Res. 55, 889–895 (1967)
Singh, B., Vaughan-Williams, E. M.: The effect of amiodarone, a new anti-anginal drug, on cardiac muscle. Br. J. Pharmacol. 39, 657–667 (1970)
Tompsett, S. L.: The spectrofluorimetric determination of phenothiazine drugs in blood serum. Acta Pharmacol. Toxicol. (Kbh.) 26, 298–302 (1968)
Vassort, G., Rougier, O., Garnier, D., Sauviat, M. P., Coraboeuf, E., Gargou, Y. M.: Effects of adrenaline on membrane inward currents during the cardiac action potential. Pflügers Arch. ges. Physiol. 309, 70–81 (1969)
Vaughan-Williams, E. M.: Classification of antiarrhythmic drugs. Symposium on cardiac arrhythmias (Sandöe, Flensted-Jensen, Olesen, eds.), pp. 449–472. Södertälje: AB Astra 1970
Vaughan-Williams, E. M., Raine, A. E. G.: Effect of prolonged betareceptor blockade on dry weight and electrophysiological responses of rabbit hearts. Lancet 1974 II, 1048–1049
Vaughan-Williams, E. M., Raine, A. E. G., Cabrera, A. A., Whyte, J. M.: The effects of prolonged β-adrenoceptor blockade on heart weight and cardiac intracellular potentials in rabbits. Cardiovasc. Res. 9, 579–592 (1975)
Wendkos, M. H., Thornton, C. C.: An electrocardiographic survey of thioridazine treated patients. Behav. Neuropsychiat. 1, 18–22 (1969)
Winer, B. J.: Statistical principles in experimental design, 2 ed., New York: McGraw-Hill 1971
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Arlock, P., Gullberg, B. & Olsson, SO.R. Cardiac electrophysiology of four neuroleptics: Melperone, haloperidol, thioridazine and chlorpromazine. Naunyn-Schmiedeberg's Arch. Pharmacol. 304, 27–36 (1978). https://doi.org/10.1007/BF00501374
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DOI: https://doi.org/10.1007/BF00501374