The Value and Limitations of Chlorpromazine in the Treatment of Anxiety States

Abstract

Chlorpromazine hydrochloride (Largactil) introduced by Laborit (1952) has aroused considerable interest on account of its varied pharmacodynamic actions and clinical reports drawing attention to its possible use in anaesthesia, general medicine and psychiatry.Chemically related to certain antihistamine drugs, it has little antihistaminic activity itself but has diverse effects on the nervous system. It is a neural depressant with central and peripheral action, vagolytic and sympatholytic properties. (Chauchard, 1952; Courvoisier, 1953; Sigwald and Boutier, 1953; Staehelin and Kielholz, 1953; Lehrman and Hanrahan, 1954; Anton-Stephens, 1954; Winkelman, 1954; Garmany, 1954; and Elkes and Elkes, 1954.)Enthusiastic claims have been made regarding the therapeutic value of chlorpromazine in a wide variety of psychiatric disorders; many of these have failed to carry conviction, as most of the reports are based on mixed groups with an insufficient number of patients in each diagnostic category to justify definite conclusions and also because controlled procedures were rarely used.We therefore decided to confine our investigation to one type of psychiatric disorder and chose anxiety states, since the reported pharmacodynamic actions of the drug suggested that it might be of value in the treatment of states of anxiety and tension. The total group studied consists of 150 patients all of whom are treated as out-patients.