Prediction of response to chlorpromazine treatment in schizophrenics

A dose of 50 mg of chlorpromazine (CPZ) was given to 6 untreated schizophrenic patients and 8 healthy volunteers at 7:00 a.m. before breakfast. Blood samples were taken 3, 6, 9 and 24 hrs after for the analyses of CPZ and its metabolites by gas chromatographic techniques. In the cases of schizophrenic patients, the CPZ treatment was continued. Serum drug levels were monitored and clinical response assessed. The drug levels in serum of another group of patients already under long term treatment were also determined. Although wide inter-patients variations in serum drug levels after a single dose administration were observed, the CPZ level in the patients decreased faster than in the normal subjects. Patients showing high levels of the metabolites such as demethylated CPZ and CPZ sulfoxide after a single dose of CPZ tended to achieve poorer clinical improvement in CPZ therapy, agreeing with the results that poor responders to long term CPZ treatment revealed relatively high levels of the metabolites of CPZ compared with CPZ level. The results indicate that the study of a single dose administration prior to initiating treatment with CPZ can be used to determine how an individual patient would respond to CPZ therapy and be a valuable tool in the rational pharmacotherapy of schizophrenic patients.

Comparison of efficacy of lithium carbonate and chlorpromazine in mania. Report of collaborative study group on treatment of mania in Japan

A multi-institutional cooperative study comparing lithium carbonate with chlorpromazine was conducted, using a controlled double-blind design in a series of 80 cases of endogenous manic psychosis, to evaluate the drugs' clinical utility and efficacy, characteristics of therapeutic effect, and side-effects. Dosages employed were consistently at an equipotent ratio of 4:1 (lithium carbonate:chlorpromazine). Physicians' overall ratings showed lithium carbonate as significantly superior to chlorpromazine in efficacy for manic psychosis. Improvements of basic mood and of disturbance in speech and voice were prominent with lithium carbonate. Onset of the therapeutic effect of lithium carbonate was within ten days of medication in 65% of the patients, significantly faster than with chlorpromazine. Side-effects encountered with lithium carbonate therapy at dose levels not higher than 1,800 mg/day were milder and less frequent compared with those seen with chlorpromazine.

Histopathological observations of spontaneous regression of Rous sarcomas in Japanese quails

Turmors induced in Japanese quails by the Schmidt-Ruppin strain of Rous sarcoma virus were examined histopathologically. The following three phases were recognized in the quails whose tumors regressed finally (regressor). Phase I was between days 4 and 7 of virus inoculation, when growth of tumor cells was seen with predominant infiltration of heterophils. Phase II, from days 10 to 14, was characterized by necrosis of tumor cells and focal accumulation of lymphoid cells which frequently formed follicle-like nodules. In phase III from days 18 to 24, tumor cells and heterophils disappeared, whereas diffuse infilitration of lymphoid cells, plasma cells and histiocytes were demonstrated. In the quails whose tumors progressed (progressor), growth of tumor cells and infiltration of heterophils at phase I seemed to follow a pattern similar to that of regressors, but subsequent infiltration and focal accumulation of lymphoid cells were rare. These morphological findings suggested an immunological reaction against tumor cells by lymphoid cells.