Chlorpromazine antipsychotic drugs

Conventional antipsychotic drugs such as chlorpromazine and haloperidol have long been used in the treatment of acute mania. More recently, atypical antipsychotic drugs including aripiprazole, olanzapine, quetiapine, risperidone, and ziprasi-done have been approved for the treatment of bipolar mania or mixed mood episodes as monotherapy or in combination with mood-stabilizing drugs.25 Aripiprazole and olanzapine are also approved for maintenance therapy. The combination of olanzapine and fluoxetine is approved for treatment of bipolar depression. Quetiapine is approved for treatment of... 

Of the antipsychotic drugs prescribed, 72% were typical antipsychotics, which included haloperidol, chlorpromazine, levomepromazine, sulpiride, trifluoperazine, fluphenazine, flupentixol, and bromperidol. Use of typical drugs was associated with longer hospitalization, male gender, and clinical reports of violence or aggression. Atypical drugs only accounted for 28% of antipsychotic drugs... 

Table 12.2 Percentages of daily dosages of antipsychotic drugs (mg chlorpromazine ...

The dosages of antipsychotic drugs differed markedly between the six sites studied (see Table 12.2). Of note, there were more than 50% of patients in China, Hong Kong, Taiwan, and Singapore taking less than 600 mg chlorpromazine-equivalents... 

Describe the historical origins of the first antipsychotic drug chlorpromazine, and evaluate the evidence for its efficacy. 

The 1950s represented a golden age for pharmacotherapy. The first antipsychotic drug, chlorpromazine, was developed in the first few years of that decade (Chapter 11), the... 

Chlorpromazine The first successful antipsychotic drug, chemically a phenothiazine. 

The positive symptoms are the most responsive to antipsychotic medications, such as chlorpromazine or halo-peridol. Initially, these drugs were thought to be specific for schizophrenia. However, psychosis is not unique to schizophrenia, and frequently occurs in bipolar disorder and in severe major depressive disorder in which paranoid delusions and auditory hallucinations are not uncommon (see Ch. 55). Furthermore, in spite of early hopes based on the efficacy of antipsychotic drugs in treating the positive symptoms, few patients are restored to their previous level of function with the typical antipsychotic medications [2]. 

Acetazolamide is a carbonic anhydrase inhibitor that reduces aqueous humour production and is therefore indicated in glaucoma to reduce the intraocular pressure. Salbutamol is a selective, short-acting beta2-agonist used as a bronchodilator in asthma. Tolbutamide is a short-acting sulphonylurea used in type 2 (non-insulin dependent) diabetes mellitus. Chlorpromazine is an aliphatic neuroleptic antipsychotic drug used in schizophrenia. Zafirlukast is a leukotriene-receptor antagonist that is indicated in the prophylaxis of asthma but should not be used to relieve acute severe asthma. 

Prochlorperazine is a potent phenothiazine antipsychotic drug that is associated with a high risk of extrapyramidal side-effects, a low degree of sedation and of antimuscarinic side-effects. Chlorpromazine is less likely to induce extrapyramidal side-effects but has increased risks of inducing sedation and antimuscarinic side-effects. Olanzapine is classified as an atypical antipsychotic having characteristically much fewer incidences of extrapyramidal... 

From the chemical point of view antipsychotic drugs are subdivided into six chemical groups, as well as to the group of non-classifiable drugs. They are phenothiazines (chlorpromazine, promazine, triflupromazine, acetophenazine, fluphenazine, perphenazine, prochlorpherazine, trifluoperazine, mesoridazine, and thioridazine), thioxanthenes... 

Detailed accounts of the discovery of chlorpromazine as an antipsychotic drug have been given by two authors (Caldwell, 1970 Swazey, 1974) an abridged... 

Antipsychotic drugs with strong sedative clinical effects (e.g. chlorpromazine. clozapine, olanzapine) produce subjective and objective sedation and impair most areas of performance in healthy volunteers, usually at doses far below those typically used in patients. Antipsychotic drugs with little sedative clinical action (e.g. pimozide, sulpiride, amisulpride) produce few subjective and objective effects in healthy... 

D2 receptor, albeit with different specificity. Older examples of dopamine antagonists are chlorpromazine, haloperidol and many derivatives of these prototype compounds. Newer antipsychotic drugs such as risperidone, olanzapine and quetiapine have retained this mechanism of action, although no longer exclusively. 

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