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Drug Plasma Levels and Clinical Effect [Abridged]

Effects ofChlorpromazine on Sleep In a somewhat different study of rapidly reversible chlorpromazine effects, low-dose treatment of four patients with sleep disturbances was carried out (unpublished data). Previously, it had been shown that doses of 100 mg of chlorpromazine improved sleep patterns, while doses of 25 mg had a reverse effect (Lewis & Evans 1969). In the present study, there was a significant increase in total sleep, and a decrease in intermittent wakefulness, and in early morning wakening, after 100 mg of chlorpromazine at bedtime. In contrast, placebo, and 100 mg of chlorpromazine in the morning, had no effect of this type on sleep patterns. Sleep was in fact slightly worse after chlorpromazineinthemorning than after placebo. Chlorpromazine determinations showed that, at bedtime, chlorpromazine given in the evening resulted in approximately a four-fold higher concentration of drug in plasma than the concentration at bedtime after a dose given in the morning. Thus a genuinely reversible effect of the drug was demonstrated.