Serum neuroleptic and prolactin levels in schizophrenic patients and clinical response.

Following a drug-free placebo period lasting at least 1 week, 10 female and 11 male newly hospitalized schizophrenic patients received chlorpromazine (CPZ) 200 mg/day for 1 week and 400 mg/day the following week. Serum CPZ equivalent (CPZ-E) levels were measured at the end of each week of CPZ treatment with a radioreceptor assay. Chlorpromazine-E levels were significantly higher in females than males, but this finding could be accounted for by differences in body weight. Serum prolactin (PRL) levels were also higher in females than males. After differences in serum CPZ-E level were adjusted for, females still had significantly higher serum PRL levels than males. Serum PRL levels increased between the first and second treatment weeks in females but not in males. Correlations between serum CPZ-E and PRL levels were higher among males than females. Significant improvement for the patient group as a whole was observed during the 2 weeks of treatment, with a strong trend for females to improve more than males. Clinical outcome at this initial period was not predicted by either serum PRL levels or serum CPZ-E levels.

Effect of (Des-Tyr)-gamma-endorphin in schizophrenia.

Des-tyrosine-gamma-endorphin (DT gamma E), a derivative of gamma-endorphin, which has been reported to have some neuroleptic-like properties in man, was administered to eight hospitalized schizophrenic patients (six chronic, one subacute, one acute) in an open study. Following an initial drug-free period, patients were given DT gamma E for 12 days in doses ranging from 1 to 10 mg/day. Two of the patients were markedly improved after receiving DT gamma E. The improvement was sustained for 2 months in one subjects, while the other deteriorated to pretreatment status within 48 hours of the discontinuation of DT gamma E. Of the other six patients, one showed moderate improvement, three showed minimal improvement, and two showed no change. Improvement was mainly in the area of social functioning; change in positive psychotic symptoms was less noticeable. The positive results obtained in this study in some subjects could have been nonspecific effects, rather than pharmacological action, since social functioning, the main area of improvement, may be especially sensitive to expectancy effects in open trials. Nevertheless, further study of DT gamma E in acute schizophrenics for longer periods appears indicated.

Effect of intramuscular chlorpromazine on serum prolactin levels in schizophrenic patients and normal controls.

Serum prolactin levels were monitored for 2 hours after injection of chlorpromazine (CPZ) 50 mg intramuscularly (i.m.) in 6 male normal controls and 14 newly admitted male chronic schizophrenics. The increase in serum prolactin levels in the male normal controls was not significantly different from that in patients. Serum prolactin levels were compared in 18 male and 22 female psychotic patients of various psychiatric diagnoses who received 50 mg of CPZ i.m., and 7 male and 6 female patients who received 25 mg CPZ i.m. No significant sex or dose differences were seen in the magnitude of the prolactin response after i.m. CPZ. These results suggest that doses of CPZ 25 or 50 mg i.m. may result in maximal prolactin secretion in most subjects and that lower doses are needed to test the hypothesis that dopamine receptors are supersensitive in schizophrenia or the affective psychoses. In six patients with mixed diagnoses, serum levels of CPZ and other active metabolites were determined by radioreceptor binding assay; peak serum drug levels were highly correlated with peak serum prolactin levels (4 = 0.92) during the first 2 hours following CPZ 50 mg i.m.

Clinical trial of topical erythromycin in inflammatory acne.

Sixty-nine informed subjects participated in a split-face, double-blind trial of topical erythromycin base 2% in Vehicle/N versus Vehicle/N alone. All subjects had grades II or III acne as described by Pillsbury. Study solutions were assigned to a randomly selected side of the subject's face. Solutions were applied twice daily. Inflammatory lesion counts were performed by the same investigator during the eight weeks of study at biweekly intervals. The difference in inflammatory lesion counts from beginning to end of study for each side of the face was compared utilizing Student's paired t-test. There was not a statistically significant difference in mean inflammatory lesions at the end of eight weeks (D = 1.46, t = 1.36, df 68). There was, however, a significant difference at two and six weeks (D = 2.59, t = 3.72, df 68; D = 1.41, t = 2.03, df 68). Observed differences in lesion counts were not considered to be clinically significant.

Serum prolactin levels following intramuscular chlorpromazine: two- and three-hour response as predictors of six-hour response.

Neuroendocrine studies that examine the changes in serum prolactin levels following intramuscular (im) neuroleptics have usually monitored prolactin levels before and for 90 minutes to 3 hours after neuroleptic injection. Recent studies have suggested that this may be an inadequate period of time. In the present study, six male and four female psychiatric inpatients, who had not received neuroleptic medication for at least 1 week before the study began, received an injection of chlorpromazine (CPZ) 25 mg im; serum prolactin levels were monitored for 6 hours after injection. Peak serum prolactin levels occurred at 60 minutes in one subject, 90 minutes in three subjects, 120 minutes in two subjects, 180 minutes in three subjects, and 240 minutes in one subject. Area under the serum prolactin curve at 2 hours and area under the curve at 3 hours after CPZ injection were found to be good predictors (r = 0.86; r = 0.95, respectively) of 6-hour area under the curve. Two-hour studies should therefore not be considered inadequate; however, a 3-hour study length results in more precise characterization of prolactin response to im CPZ.