Chlorpromazine reduces fluid-loss in cholera

Abstract

Because chlorpromazine inhibited cholera-toxin-stimulated intestinal adenylate cyclase and fluid secretion in laboratory animals its ability to reduce fluid-loss in human cholera was investigated. Eleven cholera patients with severe purging (360--1340 ml/h) were studied. Eight were given chlorpromazine intramuscularly (1 mg/kg of 4 mg/kg), and three were given a dose of 1 mg/kg by mouth. In the 32 hours after treatment there was an overall reduction in stool output of 66 +/- 5% in the chlorpromazine-treated patients. This decrease was significantly larger than the 26 +/- 9% reduction in stool output seen in patients not receiving the drug, who were observed at the same time in the course of their illness. The decrease in nausea and the mild sedation produced by chlorpromazine added to the patients' comfort. No hypotension was seen in these well-hydrated patients.

PIP: Based on positive results in laboratory animals, chlorpromazine was given a clinical trial in humans to determine if it could reduce fluid losses during cholera. In animals, the chlorpromazine inhibited cholera toxin-stimulated intestinal adenylate cyclase and fluid secretion. Therefore, 11 cholera patients suffering severe diarrhea (360-1340 ml/hour) and vomiting were given either intramuscular chlorpromazine (1 mg/kg or 4 mg/kg) (n=8) or oral chlorpromazine of the same dose (1 mg/kg) (n=3). Overall reduction in stool output of 66% in the treated patients was evident after 32 hours of treatment. The decrease in treated patients was significantly greater than the reduction in nontreated patients (26%) during the same 32-hour course of illness. Patients' comfort was also enhanced by the decrease in nausea and mild sedative qualities of chlorpromazine, and no hypotension was observed in these well-hydrated patients.