CASE REPORTS
ACUTE CHLORPROMAZINE POISONING
ARTHUR S. SAMUELS M. D.1
1 The department of psychiatry and neurology, Tulane University School of Medicine, and the Charity Hospital of Louisiana, New Orleans, La.
The signs and symptoms of acute poisoning with chlorpromazine are similar to those reported for the antihistamines, to which it is chemically related. Poisoning is characterized most prominantly by central nervous system depression. In some cases there is also a phase of central nervous system stimulation with convulsions. Other prominent signs and symptoms may include marked hypotension to shock-like levels, tachycardia, tachypnea, hypothermia, diminished or absent reflexes, hypotonia, pinpoint pupils, stomatitis, blurred vision, and slurred speech. No permanent sequelae have been reported.
Treatment is primarily symptomatic. Because of the possibility of convulsions and postictal depression, the use of stimulant drugs is not recommended(2). Noradrenalin may be effectively used to counteract hypotension. Constant vigilance should be maintained to guard against respiratory failure, with artificial respiration the treatment of choice if failure should take place. A broad-spectrum antibiotic may be used to prevent secondary infection and intravenous fluids administered to maintain fluid balance.
