An anticholinergic toxicity reaction to chlorpromazine activated by psychological stress.
A 42-year-old woman with a long-standing diagnosis of schizophrenia experienced two toxic reactions to 1200 mg of chlorpromazine while awaiting surgery for a locally metastatic carcinoma of the cervix. These reactions, which involved fever, increased pulse and respirations, and acute onset of obtundation, and which cleared after several hours, were produced by a medication and dose which had been well tolerated prior to the preoperative period. These reactions, typical of an acute anticholinergic syndrome, were precipitated by an interaction of the drug and a stress-induced change in her psychological state, due to anxiety about her cancer and impending surgery. This type of reaction has not been reported previously in a clinical setting.
D000328:Adult; D001831:Body Temperature / Q000187:drug effects; D002746:Chlorpromazine / Q000009:adverse effects* / Q000627:therapeutic use; D003221:Confusion / Q000139:chemically induced; D005260:Female; D006801:Humans; D011950:Receptors, Cholinergic / Q000187:drug effects*; D012119:Respiration / Q000187:drug effects; D012559:Schizophrenia / Q000188:drug therapy; D013315:Stress, Psychological / Q000150:complications*
D011950:Receptors, Cholinergic; D002746:Chlorpromazine