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Interactions between Procyclidine and Neuroleptic Drugs

Some Pharmacological and Clinical Aspects

Published online by Cambridge University Press:  29 January 2018

S. D. Soni*
Affiliation:
Prestwich Hospital
*
Research Department, Salford Health Authority, Prestwich Hospital, Prestwich, Manchester M25 7BL, UK

Abstract

Procyclidine was administered to 25 chronic psychotic inpatients, stabilised on chlorpromazine, haloperidol or fluphenazine decanoate injection. We observed a significant reduction in mean serum levels of all three neuroleptic drugs which was reversed on stopping procyclidine and was Inversely correlated with mean serum procyclidine levels. No significant alterations occurred on the BPRS scores or in serum prolactin levels throughout the study In any of the three groups. Possible mechanisms of this interaction and its clinical relevance are discussed.

Type
Papers
Copyright
Copyright © 1986 The Royal College of Psychiatrists 

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References

Brumlik, J., Canter, G., Dela Torre, R., Mier, M., Petrovick, M. & Boshes, B.(1964) A critical analysis of the effects of trihexyphenidyl (Artane) on the components of the parkinsonian syndrome. Journal of Mental and Nervous Diseases, 138, 424431.Google ScholarPubMed
Chouinard, G., Annable, L. & Cooper, L.(1977) Antiparkinsonian drug administration and plasma levels of penfluridol; a new, long-acting neuroleptic. Communications in Psychopharmacol., 1, 325331.Google Scholar
Conney, A. H. & Burns, J. J.(1959) Stimulatory effect of foreign compounds on ascorbic acid biosynthesis and drug-metabolising enzymes. Nature, 184, 363364.CrossRefGoogle Scholar
Conney, A. H. & Burns, J. J., Davison, C., Gastel, R. & Burns, J. J.(1960) Adaptive increases in drug metabolising enzymes induced by phenobarbital and other drugs. Journal of Pharmacy and Experimental Therapeutics, 130, 18.Google Scholar
Crane, G. E.(1973) Persistent dyskinesia. British Journal of Psychiatry, 122, 395405.CrossRefGoogle ScholarPubMed
De Rivera, J. L., Lal, S., Ettigi, P., Hontela, S., Muller, H. F. & Friesen, H. G.(1976) Effect of acute and chronic neuroleptic therapy on serum prolactin levels in men and women of different age groups. Clinical Endocrinology, 5, 273282.Google Scholar
Dimascio, A. & Demirgian, E.(1970) Antiparkinson drug overuse. Psychosomatics, XI, 596601.CrossRefGoogle Scholar
El-Yousef, M. K. & Manier, D. H.(1974) The effect of benztropine mesylate on plasma levels of butaperazine maleate. American Journal of Psychiatry, 131, 471472.CrossRefGoogle ScholarPubMed
Forsman, A. & Ohman, R.(1977) Applied pharmacokinetics of haloperidol in man. Current Therapeutic Research, 21, 396411.Google Scholar
Gautier, J., Jus, A., Villeneuve, A., Jus, K., Pires, P. & Villineuve, R.(1977) Influence of the antiparkinsonian drugs on the plasma levels of neuroleptics. Biological Psychiatry, 12, 389399.Google Scholar
Halbreich, U., Sachar, E. J., Nathan, R. S., Asnis, G. M. & Halpern, F. S.(1980) The effect of benztropine mesylate on the prolactin response to haloperidol. Psychopharmacology, 72, 6165.CrossRefGoogle ScholarPubMed
Hanlon, T. E., Schoenrich, C., Freiner, W., Turek, I. & Kerland, A. A.(1966) Perphenazine_benztropine mesylate treatment of newly admitted psychiatric patients. Psychopharmacologia (Berlin), 9, 328329.Google Scholar
Hansen, L. B., Elley, J. Christensen, T. R., Larson, N.-E., Naestoff, J. & Hvidberg, E. F.(1979) Plasma levels of perphenazine and its major metabolites during simultaneous treatment with anticholinergic drugs. British Journal of Clinical Pharmacology, 7, 7580.Google Scholar
Itoh, H., Yagi, G., Ohtsuka, N. Iwamura, K. & Ichikawa, K.(1980) Serum level of haloperidol and its clinical significance. Progress in Neuropsychopharmacology, 4, 171183.Google Scholar
Johnson, D. A. W.(1983) Is additional medication required in the maintenance treatment of schizophrenia? Lecture delivered at the Seventh World Congress of Psychiatry, Vienna. Abstracts 36–43.Google Scholar
Johnstone, E. C., Crow, T. J., Ferrier, L. N., Frith, C. D., Owens, D. G. C., Bourne, R. C. & Gamble, S. J.(1983) Adverse effects of anticholinergic medication on positive schizophrenic symptoms. Psychological Medicine, 13, 513527.Google Scholar
Klawans, H. L. & Rubovits, R.(1974) Effect of cholinergic and anticholinergic agents on tardive dyskinesia. Journal of Neurology, Neurosurgery and Psychiatry, 27, 941947.Google Scholar
Kolakowska, T., Wiles, D. H., Gelder, M. G. & McNeilly, A. S.(1976) Clinical significance of plasma chlorpromazine levels. Psychopharmacology, 49, 101107.Google Scholar
Krska, J., Sampath, G. Shah, A. & Soni, S. D.(1986) Radioreceptor assay of serum neuroleptic levels in psychiatric patients. British Journal of Psychiatry, 148, 187193.CrossRefGoogle ScholarPubMed
Lal, S., Mendis, T., Cervantes, P. Guyda, H. & de Rivera, J. L. (1979) Effect of benztropine on haloperidol-induced prolactin secretion. Neuropsychobiology, 5, 321331.Google Scholar
Lindholm, H., Gullberg, B., Ohman, A. & Sedvall, G.(1978) Effects of perphenazine enanthate injeaions on prolactin levels in plasma from schizophrenic women and men. Psychopharmacology, 57, 14.CrossRefGoogle ScholarPubMed
Linnoila, M., Viukari, M., Vaisanen, K. & Auvinen, J.(1980) Effect of anticonvulsants on plasma haloperidol and thioridazine levels. American Journal of Psychiatry, 137, 819821.Google Scholar
Loga, S., Curry, S. H. & Lader, M.(1975) Interactions of orphenadrine and phenobarbitone with chlorpromazine: plasma concentrations and effects in man. British Journal of Clinical Pharmacology, 2, 197208.Google Scholar
MacVicar, K.(1977) Abuse of antiparkinsonian drugs by psychiatric patients. American Journal of Psychiatry, 134, 809811.Google Scholar
McClelland, H. A., Blessed, G., Bhate, S., Ali, N. & Clarke, P. A.(1974) The abrupt withdrawal of antiparkinsonian drugs in schizophrenic patients. British Journal of Psychiatry, 124, 151159.Google Scholar
Mindham, R. H. S., Gaind, R., Anstee, B. H. & Rimmer, N.(1972) Comparison of amantadine, orphenadrine and placebo in the control of phenothiazine-induced parkinsonism. Psychological Medicine, 2, 406413.Google Scholar
Morselli, P. L., Zarifian, E., Cuche, H., Bianchetti, G., Cotterau, M. J. & Deniker, P.(1980) Haloperidol plasma level monitoring in psychiatric patients. In Long-Term Effects of Neuroleptics (eds Cattabeni, P. et al). New York: Raven Press, 529536.Google Scholar
Orlov, P., Kasporian, G., Dimiascio, A. & Cole, N. O.(1971) Withdrawal of antiparkinson drugs. Archives of General Psychiatry, 25, 410412.Google Scholar
Overall, J. E. & Gorham, D. R.(1962) The Brief Psychiatric Rating Scale. Psychiatric Reports, 10, 799812.Google Scholar
Rivera-Calimlim, L.(1976) Impaired absorption of chlorpromazine in rats given trihexyphenidyl. British Journal of Pharmacology, 56, 301305.Google Scholar
Rivera-Calimlim, L., Castaneda, L. & Lasagna, L.(1973) Effects of mode of management on plasma chlorpromazine in psychiatric patients. Clinical Pharmacology and Therapeutics, 14, 978986.Google Scholar
Rivera-Calimlim, L., Castaneda, L. & Lasagna, L., Nasrallah, H., Strauss, J. & Lasagna, L.(1976) Clinical response and plasma levels: Effects of dose, dosage schedules and drug interactions on plasma chlorpromazine levels. American Journal of Psychiatry, 133, 642652.Google ScholarPubMed
Shader, R. L. & Greenblatt, D. J.(1971) Uses and toxicity of belladonna alkaloids and synthetic anticholinergics. Seminars in Psychiatry, 3, 449476.Google Scholar
Simpson, G. M. & Angus, J. W. S.(1970) A rating scale for extrapyramidal side effects. Acta Psychiatrica Scandinavica (Suppl.) 212, 1119.Google Scholar
Simpson, G. M. & Angus, J. W. S., Cooper, T. B., Bark, N., Sud, I. & Lee, J. H.(1980) Effect of antiparkinsonian medication on plasma levels of chlorpromazine. Archives of General Psychiatry, 37, 205208.Google Scholar
Singh, M. M. & Kay, S. R.(1975) Therapeutic reversal with benztropine in schizophrenia. Journal of Nervous and Mental Diseases, 160, 258305.CrossRefGoogle Scholar
Singh, M. M. & Kay, S. R.(1979) Therapeutic antagonism between anticholinergic antiparkinsonism agents and neuroleptics in schizophrenia. Neuropsychobiology, 5, 7486.Google Scholar
Singh, M. M. & Kay, S. R. & Smith, J. M.(1973) Reversal of some therapeutic effeas of an antipsychotic agent by an antiparkinsonism drug. Journal of Nervous and Mental diseases, 157, 5058.Google Scholar
Stephens, D. A.(1967) Psychotoxic effects of benzhexol hydrochloride. British Journal of Psychiatry, 113, 213218.Google Scholar
Tune, L. E. & Coyle, J. T.(1980) Serum levels of anticholinergic drugs in treatment of acute extrapyramidal side effects. Archives of General Psychiatry, 37, 293297.CrossRefGoogle ScholarPubMed
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