Skip to main content
Log in

Cardiac electrophysiology of four neuroleptics: Melperone, haloperidol, thioridazine and chlorpromazine

  • Published:
Naunyn-Schmiedeberg's Archives of Pharmacology Aims and scope Submit manuscript

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.)

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Alexander, C. S., Niño, A.: Cardiovascular complications in young patients taking psychotropic drugs. Am. Heart J. 78, 757–769 (1969)

    Google Scholar 

  • 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)

    Google Scholar 

  • Arita, M., Surawicz, B.: Electrophysiologic effects of phenothiazines on canine cardiac fibres. J. Pharmacol. Exp. Ther. 184, 619–630 (1973a)

    Google Scholar 

  • Arita, M., Surawicz, B.: Electrophysiologic effects of phenothiazines on human atrial fibres. Jap. Heart. J. 14, 398–405 (1973b)

    Google Scholar 

  • Arora, R. B., Madan, B. R.: Chlorpromazine in experimental cardiac arrhythmias. J. Indian Med. Assoc. 26, 262–264 (1956)

    Google Scholar 

  • 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)

    Google Scholar 

  • Bertolo, L., Novakovic, L., Penna, M.: Antiarrhythmic effects of droperidol. Anesthesiology 37, 529–535 (1972)

    Google Scholar 

  • 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)

    Google Scholar 

  • 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)

    Google Scholar 

  • 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)

    Google Scholar 

  • 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)

    Google Scholar 

  • 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)

    Google Scholar 

  • Clementz, B., Grampp, W.: A method for rapid bevelling of micropipette electrodes. Acta Physiol. Scand. 96, 286–288 (1976)

    Google Scholar 

  • 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)

    Google Scholar 

  • Crane, G. E.: Cardiac toxicity and psychotropic drugs. Dis. Nerv. Syst. 31, 534–539 (1970)

    Google Scholar 

  • Curry, S. H.: Plasma protein binding of chlorpromazine. J. Pharm. Pharmacol. 22, 193–197 (1970)

    Google Scholar 

  • Dahl, S. G., Refsum, H.: Effects of levomepromazine, chlorpromazine and their sulfoxides on isolated rat atria. Eur. J. Pharmacol. 37, 241–248 (1976)

    Google Scholar 

  • Dahl, S. G., Strandjord, R. E.: Pharmacokinetics of chlorpromazine after single and chronic dosage. Clin. Pharmacol. Ther. 21, 437–448 (1977)

    Google Scholar 

  • Di Palma J. R., Catenacci, A. J.: Chlorpromazine protection against hydrocarbon-epinephrine induced ventricular arrhythmia. Fed. Proc. 14, 333 (1955)

    Google Scholar 

  • Forsman, A., Martensson, E., Nyberg, G., Öhman, R.: A gas chromatographic method for determining haloperidol. Naunyn-Schmiedeberg's Arch. Pharmacol. 286, 113–124 (1974)

    Google Scholar 

  • 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)

    Google Scholar 

  • 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)

    Google Scholar 

  • Giles, T. D., Modlin, R. K.: Death associated with ventricular arrhythmia and thioridazine hydrochloride. J. Am. Med. Assoc. 205, 98–100 (1968)

    Google Scholar 

  • Holland, W. C.: A possible mechanism of action of quinidine. Am. J. Physiol. 190, 492–494 (1957)

    Google Scholar 

  • 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)

    Google Scholar 

  • Hollister, L. E., Kosek, J. C.: Sudden death during treatment with phenothiazine derivates. J. Am. Med. Ass. 192, 93–96 (1965)

    Google Scholar 

  • 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)

    Google Scholar 

  • 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)

    Google Scholar 

  • 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)

    Google Scholar 

  • Klein, R. L., Holland, W. C.: Na24 and K42 exchange in atrial fibrillation. Am. J. Physiol. 193, 239–243 (1958)

    Google Scholar 

  • Klein, R. L., Holland, W. C., Tinsley, B.: Quinidine and unidirectional cation fluxes in atria. Circ. Res. 8, 246–252 (1960)

    Google Scholar 

  • 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)

    Google Scholar 

  • Landmark, K. H.: Kardiale virkninger av fenothiazinderivater. Nord. Med. 83, 617–648 (1970)

    Google Scholar 

  • 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)

    Google Scholar 

  • 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)

    Google Scholar 

  • Landmark, K.: Changes in rat atria action potentials induced by promazine and thioridazine. Acta Pharmacol. Toxicol. (Kbh.) 30, 465–479 (1971c)

    Google Scholar 

  • 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)

    Google Scholar 

  • 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)

    Google Scholar 

  • 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)

    Google Scholar 

  • 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)

    Google Scholar 

  • 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)

    Google Scholar 

  • 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)

    Google Scholar 

  • Langslet, A.: ECG-changes induced by phenothiazine drugs in the anaesthetized rat. Acta Pharmacol. Toxicol. (Kbh.) 28, 256–264 (1970a)

    Google Scholar 

  • Langslet, A.: Membrane stabilization and cardiac effects of d,l-propranolol, d-propranolol and chlorpromazine. Eur. J. Pharmacol. 13, 6–14 (1970b)

    Google Scholar 

  • Leestma, J. E., Koenig, K. L.: Sudden death and phenothiazines. Arch. Gen. Psychiat. 18, 137–148 (1968)

    Google Scholar 

  • Lingjaerde, O.: EKG-forandringer, kardiale rytmeforstyrelser og mors subita under fenothiazinbehandling. T. Norske Laegeforen. 87, 90–94 (1967)

    Google Scholar 

  • Madan, B. R., Pendse, V. K.: Antiarrhythmic activity of thioridazine hydrochloride (Mellaril). Am. J. Cardiol. 11, 78–81 (1963)

    Google Scholar 

  • 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)

    Google Scholar 

  • Melville, K. J.: Observations on the adrenergic-blocking and antifibrillatory actions of chlorpromazine. Fed. Proc. 13, 386–387 (1954)

    Google Scholar 

  • Melville, K. J.: Studies on the cardiovascular actions of chlorpromazine. I. Antiadrenergic and antifibrillatory actions. Arch. Int. Pharmacodyn. 115, 278–305 (1958)

    Google Scholar 

  • Mårtensson, E., Roos, B.-E.: Serum levels of thioridazine in psychiatric patients and healthy volunteers. Eur. J. Clin. Pharmacol. 6, 181–186 (1973)

    Google Scholar 

  • 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

    Google Scholar 

  • 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)

    Google Scholar 

  • 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)

    Google Scholar 

  • Petersen, E.: Experimental antiarrhythmic properties of melperone a neuroleptic butyrophenone. Acta Pharmacol. (Kbh.) 42, 245–251 (1978)

    Google Scholar 

  • 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)

    Google Scholar 

  • 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)

    Google Scholar 

  • Reuter, H.: The dependence of slow inward current in Purkinje fibres on the extracellular calcium-concentration. J. Physiol. (Lond.) 192, 479–492 (1967)

    Google Scholar 

  • Ruggerini, R., Grugni, P., Bolognesi, L.: L'azione antiaritmica del deidrobenzperidolo. Minerva Anaesthesiol. 36, 282–285 (1970)

    Google Scholar 

  • Seeman, P., Weinstein, J.: Erythrocyte membrane stabilization by tranquilizers and antihistamines. Biochem. Pharmacol. 15, 1737–1752 (1966)

    Google Scholar 

  • Sharma, P. L., Arora, R. B.: Antiarrhythmic activity of some phenothiazine derivates in experimental cardiac arrhythmias. Indian J. Med. Res. 49, 1099–1112 (1961)

    Google Scholar 

  • 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)

    Google Scholar 

  • 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)

    Google Scholar 

  • Tompsett, S. L.: The spectrofluorimetric determination of phenothiazine drugs in blood serum. Acta Pharmacol. Toxicol. (Kbh.) 26, 298–302 (1968)

    Google Scholar 

  • 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)

    Google Scholar 

  • Vaughan-Williams, E. M.: Classification of antiarrhythmic drugs. Symposium on cardiac arrhythmias (Sandöe, Flensted-Jensen, Olesen, eds.), pp. 449–472. Södertälje: AB Astra 1970

    Google Scholar 

  • 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

    Google Scholar 

  • 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)

    Google Scholar 

  • Wendkos, M. H., Thornton, C. C.: An electrocardiographic survey of thioridazine treated patients. Behav. Neuropsychiat. 1, 18–22 (1969)

    Google Scholar 

  • Winer, B. J.: Statistical principles in experimental design, 2 ed., New York: McGraw-Hill 1971

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

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

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00501374

Key words

Navigation