Effect of Chlorpromazine on Convulsions of Experimental and Clinical Tetanus

Management of Severe Tetanus

“…The adequate control of violent spasms without deep anaesthesia or respiratory depression was in striking and strong contrast to the effects of drugs such as rectal bromethol or sodium thiopentone by intravenous infusion. Previous reports have with one exception (Kelly and Laurence, 1956) described the use of, at most, moderate doses of chlorpromazine. Amounts of up to 200 mg. daily have been given.…”

“…In all these instances the doses used were small. Our approach to the problem has been more in line with that of Kelly and Laurence (1956). We had previously observed the effect of chlorpromazine in four patients with mild tetanus in whom it relieved muscular rigidity and minor spasms.…”

“…This drug has been shown experimentally to have properties which make it likely to be of value in tetanus. It antagonizes some central convulsant drugs (Courvoisier et al, 1953); in cats it inhibits motor activity induced by cortical stimulation and suppresses the postural responses which occur on stimulation of the cerebellar cortex and the reticular formation (Dasgupta and Werner, 1955); it abolishes local tetanus in rabbits (Hougs and Andersen, 1954;Kelly and Laurence, 1956). The injection of chlorpromazine in cats has been shown to prolong the action of relaxant drugs such as d-tubocurarine and mephenesin (Courvoisier et al, 1953); further, it has a direct paralytic effect on skeletal muscle (Burn, 1954).…”

Pathologic physiology, pharmacology, and therapeutics of tetanus

“…Chlorpromazine is a highly effective tetanus anticonvulsant in its own right, although most of those who first used it soon after its introduction into anesthesia gave it with promethazine and meperidine to produce "artificial hibernation" or else used it chiefly to potentiate other sedative agents. 81 , 254, 320 However, some had early noted its potency given alone, 112,149,199,344 although others somehow failed to get a noticeable effect. 27,192 Its efficacy in suppressing the tetanic electromyogram in man has been shown 213 , 282 and its effect on trismus measured.…”

Tetanus in African Children

“…The sedatives most commonly used in the treatment of tetanus have been magnesium sulphate, now largely abandoned, chloral hydrate, the barbiturates, bromethol and paraldehyde. Recently the use of chlorpromazine has been investigated extensively (Cole and Robertson, 1955;Kelly and Laurence, 1956).…”