CLINICAL INVESTIGATION OF CHLORPROMAZINE AND RESERPINE IN PRIVATE PSYCHIATRIC PRACTICE

One hundred and eighty private psychiatric patients received reserpine or chlorpromazine as well as standard psychiatric therapies. Of this number, 94 were hospitalized patients and 86 were office (ambulatory) patients. Results were disappointing from the standpoint of either drug producing a recovery, but encouraging in that they were superior to barbiturates in producing symptomatic improvement in anxiety, tension, manic and schizophrenic excitement, and mild insomnia. Depression per se was not alleviated by either drug. Usually, where one drug was found ineffective, so was the other. There were a few serious side-effects in our series: jaundice in 5 patients given chlorpromazine; 2 cases of cardiac collapse, and several cases of ankle and facial edema in those given reserpine. In general, neither reserpine nor chlorpromazine appeared to potentiate or interfere with standard psychiatric therapies.

Six cases are singled out for special comment. In 2 cases of morphine addiction chlorpromazine administration prevented withdrawal symptoms. Alarming cardiac collapse occurred in 2 elderly patients on reserpine. In another case, exaggeration of former gastrointestinal symptoms appeared following reserpine administration. In the sixth case reserpine failed to control hypo-manic symptoms and probably potentiated postelectroshock confusion.

The clinical nature of this study of private patients, the large proportion of whom were cases of depressive reactions, must be considered in the evaluation of results of the 2 drugs. From this clinical experience a study of the use of the drugs in selected cases is planned.