Management of acutely disturbed patients with promazine (sparine).

Abstract

• Promazine was administered either orally or parenterally to 407 acutely disturbed patients. The series consisted of 103 psychotic patients, 42 addicts experiencing withdrawal symptoms, and 262 alcoholics. The last group included 110 patients with full-blown delirium tremens, 55 with acute inebriation, and 97 with acute tremulousness and/or hallucinosis. The initial dose of promazine, ranging from 50 to 400 mg., was effective in inducing sleep in these disturbed subjects. A maintenance dose every four to six hours in most instances kept these patients in a quiescent, detached state, from which they could be easily aroused to care for their personal needs. In the agitated psychotic patients the induction of sleep was frequently associated with a dramatic return toward normal of both blood pressure and heart rate. Orthostatic hypotensive phenomena observed most frequently in the alcoholic group were not serious. Neither acute vascular collapse nor pain from intramuscular injection has been noted. Promazine appeared to potentiate the action of barbiturates and to have an antiemetic effect. During the relatively short period of treatment in these acutely disturbed patients, none of the complications reported after the use of other phenothiazine derivatives were noted.