Estudo crítico dos derivados fenotiazínicos

Blaya, Marcelo

doi:10.1590/S0004-282X1961000100005

Resumo

The author, based upon his experience with drugs and a partial review of recent literature, makes a critical evaluation of ten phenothiazinic compounds. He remarks the fact that these compounds must be studied from the viewpoint of its therapeutical and toxic effects. The author's conclusions are: 1. The phenothiazine compounds can be characterized by their chemical estructure; 2. The compounds with a lateral chain of three carbons are the most efficient. The presence of a piperil radical, and a chloride or fluoride increases the potency and side effects; 3. None of the studied compounds is entirely without side effects; 4. The therapeutic effects are equivalent, when the compounds are used in proportional dosages; 5. Among the compounds, promazine and levopromazine are the ones that combine the best therapeutic effect with the less incidence of side effects.

Estudo crítico dos derivados fenotiazínicos

Critical evaluation of phenothiazinic derivatives

Marcelo Blaya

Docente Livre de Psiquiatria da Fac. de Med. de Pôrto Alegre. Diretor da Clínica Pinel

ABSTRACT

The author, based upon his experience with drugs and a partial review of recent literature, makes a critical evaluation of ten phenothiazinic compounds. He remarks the fact that these compounds must be studied from the viewpoint of its therapeutical and toxic effects. The author's conclusions are: 1. The phenothiazine compounds can be characterized by their chemical estructure; 2. The compounds with a lateral chain of three carbons are the most efficient. The presence of a piperil radical, and a chloride or fluoride increases the potency and side effects; 3. None of the studied compounds is entirely without side effects; 4. The therapeutic effects are equivalent, when the compounds are used in proportional dosages; 5. Among the compounds, promazine and levopromazine are the ones that combine the best therapeutic effect with the less incidence of side effects.

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Trabalho apresentada na Primeira Jornada Sul-Riograndense de Psiquiatria Dinâmica (Gramado, 1960).

Clínica Pinel - Av. João Pessoa, 943 - Pôrto Alegre, Rio Grande do Sul - Brasil.

1. ABSE, D. W. - Evaluation of tranquilizing drugs in the management of acute mental disturbances. Am. J. Psychiat., 116:973, 1960.
2. BARSA, J. A. - Trifluoperazine combined with Chlorpromazine. Am. J. Psychiat., 116:925, 1980.
3. BARSA, J. A.; SAUNDERS, J. C.; KLINE, N. S. - Trifluoperazine in the treatment of chronic schizophrenics. Am. J. Psychiat., 115:812, 1959.
4. BIRD, E. G.; GROSS, J. D.; DENBER, H. C. B. - Chlorpromazine in the treatment of mental illness: a study of 750 patients. Am. J. Psychiat., 111:930, 1955.
5. CAHAN, R. B. - Efficacy of Trifluoperazine in chronic mental illness. Am. J. Pychiat, 116:838, 1960.
6. CAHAN, R. B.; PARRISH, D. D. - Reversibility of drug-induced parkinsonism. Am. J. Psychiat., 116:1021, 1960.
7. CASEY, J. F.; LASKY, J. J.; KLETT, C. J.; HOLLISTER, L. E. - Treatment of schizophrenic reactions with phenotiazine derivatives. Am. J. Psychiat., 117:97, 1960.
8. CATTELL, J. P. - Psychopharmacological agents: a selective survey. Am. J. Psychiat., 116:352, 1959.
9. COUNCIL ON PHARMACY AND CHEMISTRY - Blood dyscrasias associated with Chlorpromazine therapy. J.A.M.A., 160:287, 1956.
10. ERDOS, J. M.; HILLINGER, J. - Trifluoperazine in refractory schizophrenic patients. Am. J. Psychiat., 116:1026, 1960.
11. FELDMAN, P. E. - A comparative study of various ataractic drugs. Am. J. Psychiat., 113:589, 1957.
12. FELDMAN, P. E. e outros - A controlled blind study of effects of Thorazine on psychotic behavior. Bull. Menninger Clin., 20:25, 1956.
13. FISCHER, A.; GOTTREICH, N. S. - Anemia as a complication of Proclorperazin'i therapy. Am. J. Psychiat., 116:932, 1960.
14. FREYHAN, F. A. - Therapeutic implications of differential effects of new phenotiazine compounds. Am. J. Psychiat., 115:577, 1958.
15. GOLDMAN, D. - The Effect of Chlorpromazine on Severe Mental and Emotional Disturbances. In Chlorpromazine and Mental Health. Lea & Febiger, Philadelphia, 1955.
16. GOSLINE, E.; WALTERS, C. J.; SAUNDERS, J. C. - Clinical report on Methoxypromazine: a new Phenotiazine. Am. J. Psychiat., 115:939, 1959.
17. GRAFFEO, A. J. - Three years of treatment of chronic hospitalized psychotic individuals with Promazine. Am. J. Psychiat., 116:842, 1960.
18. HAMLON, J. S.; LARSON, A. N.; SINES, L. K. - A note on the clinical effects of Perphenazine at a very high dosage. Am. J. Psychiat., 116:456, 1959.
19. HODGES, H. H.; LAZERTE, G. D. - Jaundice and agranulocytosis with fatality following Chlorpromazine therapy. J.A.M.A., 158:114, 1955.
20. HOLLISTER, L. E. - Complications from the use of tranquilizing drugs. New England J. Med., 259:170, 1957.
21. HOLT, J. P.; WRIGHT, E. R. - Preliminary results with Fluphenazine in chronic psychotic patients. Am. J. Psychiat., 117:157, 1960.
22. JACOBY, M. G. - Treatment with high dosage of Trifluopromazine. Am. J. Psychiat., 116:555, 1959.
23. KING, P. D.; WEINBERGER, W. - Comparison of Prochlorperazine and Chlorpromazine in hospitalized chronic schizophrenics. Am. J. Psychiat., 115:1026, 1959.
24. KRUSE, W. - Effect of Trifluoperazine on auditory hallucinations. Am. J. Psychiat., 116:318, 1959.
25. KRUZE, W. - Experience with Trifluoperazine in 110 female schizophrenics. Am. J. Psychiat., 115:1031, 1959.
26. LABORIT, H.; HUGUENARD, P.; ALLUAME, R. - Un nouveau stabilisateur végétatif (LE4560 RP). Presse Méd. 60:206, 1952.
27. LINN, I. L. - Sources of uncertainly in studies of drugs affeting mood, mentation or activity. Am. J. Psychiat, 116:97, 1959.
28. MAY, R. H. - Catatonic-like states following Phenotiazine therapy. Am. J. Psychiat., 115:1119, 195S.
29. PACHECO E SILVA, A. C. e outros - O emprêgo de clorpromazina em doses maciças (sindromo de impregnação). Publicações Médicas, 28:198, 1957.
30. PENNINGTON, V. M. - The phrenotropic action of Perphenazine in 323 neuropsychiatric patients. Am. J. Psychiat., 116:65, 1959.
31. PENNINGTON, V. M. - Proclorperazine in the treatment of the schizophrenics. Am. J. Psychiat, 115:820, 1959.
32. REZNIKOFF, L. - Experience with Trifluoperazine in treatment of 100 chronic anergic schizophrenics. Am. J. Psychiat, 116:1024, 1960.
33. RIESENMAN, F. R.; PETTIT, M. B. - Clinical efficacy of Prochlorperazine in mental illness. Am. J. Psychiat, 115:1032, 1959.
34. SHAWVER, J. R.; TARNOWSKI, S. M. - Thrombocytopenia in prolonged Chlorpromazine therapy. Am. J. Psychiat, 116:845, 1960.
35. SMITH, J. A. e outros - A graphic comparison of five phenotiazines. Am. J. Psychiat, 116:392, 1959.
36. SMITH, J. A. e outros - A comparison of Tri-fluopromazine, Chlorpromazine and placebo in 85 chronic patients. Am. J. Psychiat, 115:253, 1958.
37. SUSSMAN, R. M.; SUMNER, P. - Jaundice following the administration of 50 mg of Chlorpromazine. New England J. Med, 253:499, 1955.
38. TAYLOR, I. J. - Clinical evaluation of Flufenazine. Am. J. Psychiat, 116:457, 1959.
39. TOLAN, E. J.; PEPPEL, H. H. - Preliminary observations on Trifluoperazine in schizophrenia. Am. J. Psychiat, 115:935, 1959.

Datas de Publicação

Publicação nesta coleção
05 Dez 2013
Data do Fascículo
Mar 1961

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ABSE, D. W. - Evaluation of tranquilizing drugs in the management of acute mental disturbances. Am. J. Psychiat., 116:973, 1960.

[2] 2. BARSA, J. A. - Trifluoperazine combined with Chlorpromazine. Am. J. Psychiat., 116:925, 1980.

[3] 3. BARSA, J. A.; SAUNDERS, J. C.; KLINE, N. S. - Trifluoperazine in the treatment of chronic schizophrenics. Am. J. Psychiat., 115:812, 1959.

[4] 4. BIRD, E. G.; GROSS, J. D.; DENBER, H. C. B. - Chlorpromazine in the treatment of mental illness: a study of 750 patients. Am. J. Psychiat., 111:930, 1955.

[5] 5. CAHAN, R. B. - Efficacy of Trifluoperazine in chronic mental illness. Am. J. Pychiat, 116:838, 1960.

[6] 6. CAHAN, R. B.; PARRISH, D. D. - Reversibility of drug-induced parkinsonism. Am. J. Psychiat., 116:1021, 1960.

[7] 7. CASEY, J. F.; LASKY, J. J.; KLETT, C. J.; HOLLISTER, L. E. - Treatment of schizophrenic reactions with phenotiazine derivatives. Am. J. Psychiat., 117:97, 1960.

[8] 8. CATTELL, J. P. - Psychopharmacological agents: a selective survey. Am. J. Psychiat., 116:352, 1959.

[9] 9. COUNCIL ON PHARMACY AND CHEMISTRY - Blood dyscrasias associated with Chlorpromazine therapy. J.A.M.A., 160:287, 1956.

[10] 10. ERDOS, J. M.; HILLINGER, J. - Trifluoperazine in refractory schizophrenic patients. Am. J. Psychiat., 116:1026, 1960.

[11] 11. FELDMAN, P. E. - A comparative study of various ataractic drugs. Am. J. Psychiat., 113:589, 1957.

[12] 12. FELDMAN, P. E. e outros - A controlled blind study of effects of Thorazine on psychotic behavior. Bull. Menninger Clin., 20:25, 1956.

[13] 13. FISCHER, A.; GOTTREICH, N. S. - Anemia as a complication of Proclorperazin'i therapy. Am. J. Psychiat., 116:932, 1960.

[14] 14. FREYHAN, F. A. - Therapeutic implications of differential effects of new phenotiazine compounds. Am. J. Psychiat., 115:577, 1958.

[15] 15. GOLDMAN, D. - The Effect of Chlorpromazine on Severe Mental and Emotional Disturbances. In Chlorpromazine and Mental Health. Lea & Febiger, Philadelphia, 1955.

[16] 16. GOSLINE, E.; WALTERS, C. J.; SAUNDERS, J. C. - Clinical report on Methoxypromazine: a new Phenotiazine. Am. J. Psychiat., 115:939, 1959.

[17] 17. GRAFFEO, A. J. - Three years of treatment of chronic hospitalized psychotic individuals with Promazine. Am. J. Psychiat., 116:842, 1960.

[18] 18. HAMLON, J. S.; LARSON, A. N.; SINES, L. K. - A note on the clinical effects of Perphenazine at a very high dosage. Am. J. Psychiat., 116:456, 1959.

[19] 19. HODGES, H. H.; LAZERTE, G. D. - Jaundice and agranulocytosis with fatality following Chlorpromazine therapy. J.A.M.A., 158:114, 1955.

[20] 20. HOLLISTER, L. E. - Complications from the use of tranquilizing drugs. New England J. Med., 259:170, 1957.

[21] 21. HOLT, J. P.; WRIGHT, E. R. - Preliminary results with Fluphenazine in chronic psychotic patients. Am. J. Psychiat., 117:157, 1960.

[22] 22. JACOBY, M. G. - Treatment with high dosage of Trifluopromazine. Am. J. Psychiat., 116:555, 1959.

[23] 23. KING, P. D.; WEINBERGER, W. - Comparison of Prochlorperazine and Chlorpromazine in hospitalized chronic schizophrenics. Am. J. Psychiat., 115:1026, 1959.

[24] 24. KRUSE, W. - Effect of Trifluoperazine on auditory hallucinations. Am. J. Psychiat., 116:318, 1959.

[25] 25. KRUZE, W. - Experience with Trifluoperazine in 110 female schizophrenics. Am. J. Psychiat., 115:1031, 1959.

[26] 26. LABORIT, H.; HUGUENARD, P.; ALLUAME, R. - Un nouveau stabilisateur végétatif (LE4560 RP). Presse Méd. 60:206, 1952.

[27] 27. LINN, I. L. - Sources of uncertainly in studies of drugs affeting mood, mentation or activity. Am. J. Psychiat, 116:97, 1959.

[28] 28. MAY, R. H. - Catatonic-like states following Phenotiazine therapy. Am. J. Psychiat., 115:1119, 195S.

[29] 29. PACHECO E SILVA, A. C. e outros - O emprêgo de clorpromazina em doses maciças (sindromo de impregnação). Publicações Médicas, 28:198, 1957.

[30] 30. PENNINGTON, V. M. - The phrenotropic action of Perphenazine in 323 neuropsychiatric patients. Am. J. Psychiat., 116:65, 1959.

[31] 31. PENNINGTON, V. M. - Proclorperazine in the treatment of the schizophrenics. Am. J. Psychiat, 115:820, 1959.

[32] 32. REZNIKOFF, L. - Experience with Trifluoperazine in treatment of 100 chronic anergic schizophrenics. Am. J. Psychiat, 116:1024, 1960.

[33] 33. RIESENMAN, F. R.; PETTIT, M. B. - Clinical efficacy of Prochlorperazine in mental illness. Am. J. Psychiat, 115:1032, 1959.

[34] 34. SHAWVER, J. R.; TARNOWSKI, S. M. - Thrombocytopenia in prolonged Chlorpromazine therapy. Am. J. Psychiat, 116:845, 1960.

[35] 35. SMITH, J. A. e outros - A graphic comparison of five phenotiazines. Am. J. Psychiat, 116:392, 1959.

[36] 36. SMITH, J. A. e outros - A comparison of Tri-fluopromazine, Chlorpromazine and placebo in 85 chronic patients. Am. J. Psychiat, 115:253, 1958.

[37] 37. SUSSMAN, R. M.; SUMNER, P. - Jaundice following the administration of 50 mg of Chlorpromazine. New England J. Med, 253:499, 1955.

[38] 38. TAYLOR, I. J. - Clinical evaluation of Flufenazine. Am. J. Psychiat, 116:457, 1959.

[39] 39. TOLAN, E. J.; PEPPEL, H. H. - Preliminary observations on Trifluoperazine in schizophrenia. Am. J. Psychiat, 115:935, 1959.