Circulatory studies during physical exercise in mentally disordered patients. I. Effects of large doses of chlorpromazine.

Abstract

Abstract 1. Nine patients who were not given chlorpromazine (mean age 29 years), and eight patients (mean age 30 years) who received large doses of chlorpromazine (1500–3600 mg/day) were studied, with determination of oxygen uptake, ventilation, cardiac output, arterial blood pressure and arterial blood lactate, pyruvate and noradrenaline concentrations at rest supine, and when cycling in the sitting position on a bicycle ergometer with successively increasing work loads. The heart volume was measured roentgenologically with the patient prone. 2. Four patients were studied before, and 1.5–5 months after, the beginning of chlorpromazine treatment. They maintained their physical performance during that period. 3. All patients had a low physical working capacity on the bicycle ergometer; and most of them had a reduced stroke volume in relation to the heart volume. 4. The patients treated with chlorpromazine tended to show further reduction in stroke volume and lower cardiac output during exercise than those who did not receive such treatment. 5. The arterial blood pressure at rest was largely the same in the two groups of patients, but was reduced during exercise in those treated with chlorpromazine. Chlorpromazine did not cause a significant change in peripheral vascular resistance. 6. A high blood noradrenaline level was recorded during exercise after treatment with chlorpromazine. 7. A small stroke volume, especially in patients treated with chlorpromazine, and the fall in arterial blood pressure in this group, are factors that limit physical performance. The importance is stressed of exercise tests in clinical routine in the activation of patients receiving phenothiazines, at least for those receiving large doses.