Drowsiness chlorpromazine

Other psychiatrists noted early on how it produced a calming effect with a minimum of drowsiness and confusion (Hoch, Lesse, Malitz 1956), psychic indifference (Anton-Stephens 1954) and a pathological tranquillity of mind (Winkelman, Jr. 1957). Hans Lehmann, the first North American psychiatrist to use chlorpromazine described it as having the power to quiet severely excited patients without rendering them... 

These drugs were developed by introducing structural changes into first-generation diphenylmethane histamines that, as side reactions, were observed to cause drowsiness and exhibited sedative effects. A-Phenylation of m-chloroaniline is the first step in the synthesis of the phenothiazine chlorpromazine (146) (Scheme 29), structurally related to methylene blue (see Chapter l)81. It is used for treatment of mental disease, including schizophrenia. 

The detrimental effects of alcohol on the skills related to driving are made worse by chlorpromazine, and, to a lesser extent, by flu-pentixol, sulpiride and thioridazine. Small or single-dose studies with haloperidol or tiapride surest that any interaction would seem to be mild nevertheless, all antipsychotic drugs which cause drowsiness have the potential to enhance the effects of alcohol. There is evidence that drinking can precipitate the emergence of extrapyramidal adverse effects in patients taking antipsychotics. 

The documentation is limited. The manufacturers of flupentixoP and haloperidol warn that, in common with other antipsychotic drugs, the effects of alcohol maybe enhanced. Warn patients that if they drink alcohol while taking chlorpromazine, and to a lesser extent flupenthixol, sulpiride or thioridazine (probably other related drugs as well), they may become very drowsy, and should not drive or handle other potentially dangerous machinery. Some risk is possible with any antipsychotic that causes drowsiness, including those used as antiemetics, such as prochlorperazine. 

Clinically relevant interactions were not noted when moclobemide was given with one or more neuroleptics (including phenothiazines such as chlorpromazine, levomepromazine, thioridazine). Adverse effects such as hypotension, tachycardia, drowsiness, tremor, and constipation were somewhat more Sequent, probably due to additive effects. A fatal case of overdose with moclobemide and perazine was attributed to syn-ergisSc effects resulSng in funcSonal cardiovascular disorder. ... 

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