Chlorpromazine in Geriatric Psychiatry

Fifty patients in the psycho‐geriatric unit of a county hospital were divided randomly into two groups; 30 were treated with chlorpromazine for six weeks, and 20 constituted the controls. The morning blood pressure (with the patient in the standing position) was used to monitor chlorpromazine dosage; the highest dosage reached was 200 mg daily (5 cases), but in 11 cases the dosage could be only 50 mg daily. Improvement was assessed by means of Rating Scales (NOSIE and BPRS) and Global Assessment. Chloral hydrate and phenobarbital were prescribed as needed during the trial. No significant differences were found between the groups on the basis of the rating scales or global assessment. Nonsignificant trends favored the chlorpromazine group. (Two patients in the original control group had to be dropped from the study because chlorpromazine therapy was necessary to control violent agitated behavior.) Side effects observed more commonly in the chlorpromazine group were tremor, weight gain, and nasal congestion. Drowsiness, fatigue, unsteadiness, falling, constipation, and abnormal facial movements were no more common in the chlorpromazine group than in the control group.