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At least 253 records · Page 14Linked to original sources
PubMed1993

Determination of chlorpromazine in human breast milk and serum by high-performance liquid chromatography.

A high-performance liquid chromatographic (HPLC) assay was developed for the determination of chlorpromazine in serum and human breast milk. Chlorpromazine in serum and human breast milk was extracted by a rapid and simple procedure based on C18 bonded-phase extraction, and a reversed-phase HPLC separation technique was developed. Chlorpromazine and levomepromazine as the internal standard were detected by ultraviolet absorbance at 254 nm. Determination was possible for chlorpromazine in the concentration range 10-300 ng/ml. The recoveries of chlorpromazine added to serum and human breast milk were 80.1-87.6 and 80.3-84.4%, respectively, with coefficients of variation of less than 10.2 and 7.8%. The method is applicable to drug level monitoring in the serum and human breast milk of patients treated with chlorpromazine.

Chlorpromazine↗
PubMed1994

Quantification of chlorprothixene, levomepromazine and promethazine in human serum using high-performance liquid chromatography with coulometric electrochemical detection.

Isocratic reversed-phase high-performance liquid chromatography with coulometric electrochemical detection was optimised to quantify the neuroleptic drugs chloroprothixene, levomepromazine, and promethazine in human serum. The method involves extraction of the neuroleptic drugs in n-heptane-isoamylalcohol from the alkalinized serum, followed by chromatographic separation on a Nucleosil CN column with acetonitrile-pyridine-sodium acetate buffer as the mobile phase. The extraction recovery was > 85% for each neuroleptic drug. The sensitivity and selectivity required for pharmacokinetic studies was obtained with a dual coulometric analytical cell operating in the oxidative screen mode. The lower limit of detection in human serum for chlorprothixene, levomepromazine, and promethazine, was 0.5, 0.2 and 0.1 ng/ml, respectively. A linear relationship (r2 > 0.99) was obtained between the concentrations of each neuroleptic drug and the detector signal. The accuracy of the quality control samples was +/- 7% for each neuroleptic drug with a precision within 9.5%, 8.1% and 13.5% for chlorprothixene, levomepromazine, and promethazine, respectively. The neuroleptic drugs were stable in acetonitrile and human serum for at least six months when stored at -20 degrees C. This method is applicable to analyze a large number of serum samples for pharmacokinetic studies of the neuroleptic drugs.

Chlorprothixene↗
PubMed1987

The effects of intermittent drug therapy on stereotypy and collateral behaviors of mentally retarded persons.

A double-blind, placebo-controlled study was conducted to assess the effects of intermittent drug therapy on stereotyped and collateral behaviors of six profoundly mentally retarded, institutionalized, adult males. The subjects, all of whom had received antipsychotic medication for more than three years, had their maintenance dosages gradually reduced by almost half during the eight-month study. A multiple baseline across subjects design was utilized to assess drug effects on object and body stereotypy and a range of collateral behaviors. While there was individual variation across behaviors and subjects, the main finding was that despite the marked reduction in medication, there were no general changes of clinical significance in any of the behaviors. This finding is of considerable therapeutic importance since a very large number of institutionalized mentally retarded persons receive similar long-term medication for behavior problems and there is some concern regarding the adverse side effects of such treatment.

Adolescent↗
PubMed2006

Simultaneous determination of the antipsychotic drugs levomepromazine and clozapine and their main metabolites in human plasma by a HPLC-UV method with solid-phase extraction.

A HPLC method with UV detection has been developed for the simultaneous determination of levomepromazine, clozapine and their main metabolites: N-desmethyl-levomepromazine, levomepromazine sulphoxide, O-desmethyl-levomepromazine, N-desmethylclozapine and clozapine N-oxide. The analytes were separated on a C8 reversed-phase column using a mobile phase composed of acetonitrile and a pH 2.0, 34 mM phosphate buffer containing 0.3% triethylamine (29:71, v/v). Loxapine was used as the internal standard. A reliable biological sample pre-treatment procedure by means of solid-phase extraction on C1 cartridges was implemented, which allows to obtain good extraction yields (>91%) for all analytes and appropriate sample purification from endogenous interference. The method was validated in terms of extraction yield, precision and accuracy. These assays gave RSD% values for precision always lower than 4.9% and mean accuracy values higher than 92%. The method is suitable for the therapeutic drug monitoring (TDM) of patients undergoing polypharmacy with levomepromazine and clozapine.

Antipsychotic Agents↗
PubMed2006

A fatal case of amoxapine poisoning under the influence of chronic use of psychotropic drugs.

A 43-year-old woman was found dead in a car in the supine position. She had been suffering from depression for 2 years and hesitation wounds on the left forearm and wrist were observed. On microscopic examination, pulmonary congestion and edema were observed with heart failure cells in many alveoli, thereby suggesting not only acute but also chronic heart failure. Drug screening in the blood by gas chromatography-mass spectrometry (GC-MS) revealed the presence of amoxapine and levomepromazine, and their concentrations in tissues were determined by GC-MS with three-step solvent extraction followed by acetylation. The concentration of amoxapine in the blood and liver was 0.86-1.77 and 18.76microg/ml, respectively; the levels were much higher than the therapeutic level but did not reach the lethal level. The concentrations of levomepromazine in tissues were within the therapeutic level. Based on the pathological and toxicological findings, the cause of death was determined to be amoxapine poisoning on the basis of chronic heart failure due to the chronic use of psychotropic drugs.

Adult↗
PubMed2006

Possible levomepromazine-clozapine interaction: two case reports.

OBJECTIVE: To report and comment upon two cases of suspected pharmacological interaction between the "classical" neuroleptic levomepromazine (LMP) and the "atypical" antipsychotic clozapine (CLZ). CASE SUMMARY: The patients who simultaneously took the two drugs had unusually low plasma levels of CLZ and its metabolites, even though they took high doses of CLZ. The patients were considered "non-responders" to the treatment by the psychiatrist. When LMP was withdrawn from the therapy, plasma concentrations of CLZ returned to therapeutic levels and one of the two patients experienced the anticipated therapeutic response. DISCUSSION: No information can be found in the literature regarding possible interactions between LMP and CLZ. However, the results of the two cases reported herein point out to a possible lack of therapeutic efficacy of CLZ therapy during this kind of polypharmacy. CONCLUSION: While two cases are too few to draw any conclusion, it would be prudent on the part of psychiatrists to consider a possible drug interaction in patients receiving both CLZ and LMP who fail to respond to the therapy.

Adolescent↗
PubMed2005

The use of levomepromazine in Hyperemesis Gravidarum resistant to drug therapy--a case series.

Hyperemesis Gravidarum (HG) is a potentially serious complication of early pregnancy, which may rarely be severe enough to warrant termination of pregnancy. HG requires prompt treatment with intravenous fluids, thiamine supplementation and appropriate anti-emetic therapy. Anti-histamines such as promethazine are favoured as first-line agents, with prochlorperazine being used as a second-line drug. However, there is no clear data as to the most appropriate drug if these are ineffective. A case series of six women who presented with HG resistant to drug treatment is described. In these cases, levomepromazine 6.25mg tds was used to control HG. Five pregnancies progressed leading to live born infants with no evidence of congenital anomaly. One pregnancy resulted in an intra-uterine death with no external or ultrasound evidence of congenital anomaly. The role of phenothiazines in the pharmacological management of HG is discussed.

Adolescent↗
PubMed2002

[Reversible cardiomyopathy induced by psychotropic drugs: case report and literature overview].

A number of psychotropic drugs, including tricyclic antidepressants, phenothiazine and lithium, have a well demonstrated risk of cardiotoxicity. Each individual therapeutic class has potentially deleterious effects on electrophysiology and myocardial function. The authors report a case showing how serious side effects may result from the association of these different classes in the presence of a coexistent heart disease, even when the underlying disease is mild.

Aged↗