Chlorpromazine

Cardiovascular

The possibility that some of the cardiac effects of chlorpromazine may be related to metabolites as well as the parent compound has been explored [ , ].

Some cases of sudden death in apparently young healthy individuals may be directly attributable to cardiac dysrhythmias after treatment with thioridazine or chlorpromazine [ ].

Nervous system

In 15 schizophrenic inpatients aged 16–55 years, there was a 50% probability that a patient would have a tremor when the plasma concentration of chlorpromazine was 46 ng/ml or more, corresponding to the minimum plasma concentration that has been associated with a good clinical response [ ].

Sensory systems

Deposits in the cornea and lens can complicate long-term chlorpromazine therapy and in vivo confocal imaging of such deposits has now been reported, supposedly for the first time [ ].

• A 59-year-old woman who for 20 years had taken chlorpromazine up to 1200 mg/day (mean dose 400 mg/day) gradually developed blurred vision in her left eye. Slit-lamp biomicroscopy showed multiple fine creamy-white deposits on her corneal endothelium and anterior crystalline lens capsule bilaterally. Microstructural analysis of the corneal endothelium showed that there were no abnormalities in cellular morphology resulting from these deposits.

Skin

Chlorpromazine causes photosensitivity reactions (incidence around 3%), which may result from formation of a cytotoxic by-product after exposure to ultraviolet light. Patients should be advised to avoid prolonged exposure to strong indoor light, to wear protective clothing, and to use a combined para-aminobenzoic acid plus benzophenone sunscreen when exposure to strong sunlight is unavoidable.

Toxic epidermal necrolysis has been reported in association with chlorpromazine [ ].

Chlorpromazine is thought to have caused an immunologically mediated contact urticaria [ ].