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Journal of Analytical Toxicology Aug 2022Promazine is one of the oldest phenothiazine derivatives that have been proposed for the treatment of various psychiatric disorders. The drug is available as tablets, as...
Promazine is one of the oldest phenothiazine derivatives that have been proposed for the treatment of various psychiatric disorders. The drug is available as tablets, as syrups and in injectable forms. Despite its prescription to millions of subjects, its detection in human hair has seldom been reported. The aim of the present work is to develop a specific method to identify promazine in human hair by liquid chromatography-tandem mass spectrometry and to apply it to a patient who was self-medicating. The method involves overnight incubation of 20 mg of cut hair in 1 mL of pH 9.5 borate buffer in the presence of amitriptyline-d3 at 40°C. The chromatographic separation was performed using a reverse phase column HSS C18 with a gradient elution for 15 min. Linearity was verified from 0.5 to 500 pg/mg (r2 = 0.9996), after spiking blank hair with the corresponding amounts of promazine. The limit of detection was estimated at 0.1 pg/mg. The precision was lower than 20%. Promazine was detected in the hair of a psychotic subject at 228-270 pg/mg in a 3 × 1 cm segment. Given this was a patient who was self-medicating, her physician requested an immediate drug discontinuation. In a fresh hair specimen collected 3 months later, the proximal segment (0-1 cm) tested positive at 0.9 pg/mg, clearly indicating that the time to obtain a negative result after promazine discontinuation is about 3-4 months.
Topics: Chromatography, Liquid; Female; Hair; Humans; Promazine; Substance Abuse Detection; Tandem Mass Spectrometry
PubMed: 34518883
DOI: 10.1093/jat/bkab101 -
Contact Dermatitis Sep 2017
Topics: Aged; Antipsychotic Agents; Dermatitis, Photoallergic; Humans; Male; Promazine
PubMed: 28766806
DOI: 10.1111/cod.12797 -
The American Journal of Psychiatry Dec 1961
Topics: Counseling; Electroconvulsive Therapy; Humans; Mental Disorders; Promazine; Psychotherapy
PubMed: 14490531
DOI: 10.1176/ajp.118.6.504 -
Polish Journal of Pharmacology 1997The aim of the present study was to search for a possible effect of tricyclic antidepressants on the pharmacokinetics of promazine. Male Wistar rats received promazine...
The aim of the present study was to search for a possible effect of tricyclic antidepressants on the pharmacokinetics of promazine. Male Wistar rats received promazine and/or an antidepressant (amitriptyline, imipramine) at a dose of 10 mg/kg i.p. twice a day for two weeks. Amitriptyline increased the plasma concentrations of promazine and N-desmethylpromazine. The concentration of promazine sulfoxide was lowered after 30 min, but later it was raised after 6 and 12 h. The interaction was pronounced after 6 and 12 h when the concentration of promazine was 3 times as high, that of N-desmethylpromazine 25 times as high, and that of sulfoxide 22 times as high as those observed after administration of promazine alone. Similar results were obtained in the brain. Imipramine produced less distinct changes in promazine pharmacokinetics. It did not produce any significant changes in promazine concentration (a tendency to raise it after 30 min was observed) in plasma, but it significantly increased the concentration of N-desmethylpromazine and decreased that of promazine sulfoxide. Changes in the brain did not follow closely those in the plasma. In the brain, significant increases in the levels of promazine and its metabolites were observed after 6 and 12 h. In vitro studies with liver microsomes showed that chronic co-administration of the antidepressants did not significantly influence the rate of promazine demethylation and sulfoxidation. Instead, the Lineweaver-Burk's analysis showed that both amitriptyline and imipramine competitively inhibited the two metabolic pathways of the neuroleptic. The potency of imipramine to inhibit the promazine metabolism in vitro was lower than that of amitriptyline, which was in line with its weaker effect on the pharmacokinetics of promazine in vivo. The observed increase in the sum of concentrations of the measured compounds (promazine + metabolites) in the plasma suggests additional inhibition by amitriptyline of another, metabolic pathway of promazine (e.g. hydroxylation). It is concluded that amitriptyline and imipramine which interfere with the metabolism (and probably distribution) of promazine produce potent increases in the brain (in the case of amitriptyline also in the plasma) concentrations of the neuroleptic.
Topics: Amitriptyline; Animals; Antidepressive Agents, Tricyclic; Antipsychotic Agents; Brain; Drug Interactions; Imipramine; In Vitro Techniques; Male; Microsomes, Liver; Mixed Function Oxygenases; Promazine; Rats; Rats, Wistar; Tissue Distribution
PubMed: 9566049
DOI: No ID Found -
Journal of the American Medical... May 1957
Topics: Phenothiazines; Promazine; Tranquilizing Agents
PubMed: 13415961
DOI: No ID Found -
Psychiatria Danubina Jun 2011Delusional parasitosis (DP) is an uncommon and complex to treat form of delusional disorder, somatic type. The syndrome may occur in association with a number of...
Delusional parasitosis (DP) is an uncommon and complex to treat form of delusional disorder, somatic type. The syndrome may occur in association with a number of psychotic disorders, such as schizophrenia, organic mental disorder, or even in dementia with behavioral and psychological symptoms. Evidence of efficacy of treatment options is weak and there is little known about the specific use of typical and atypical antipsychotics. We report on a case of primary DP in a 75-year-old Caucasian woman with a 3-year-long history of dermatological consultations due to unspecified complains who responded to the typical antipsychotic promazine. This case is unique in pharmacological respect as it presents the first reported DP treatment with promazine. It also raises the issue of efficacy and safety of low-potency typical antipsychotics in the elderly population.
Topics: Aged; Antipsychotic Agents; Delusions; Female; Humans; Promazine; Psychotic Disorders; Treatment Outcome
PubMed: 21685861
DOI: No ID Found -
The American Journal of Psychiatry Mar 1962
Topics: Depression; Depressive Disorder; Imipramine; Promazine
PubMed: 14487609
DOI: 10.1176/ajp.118.9.842 -
The American Journal of Psychiatry Jan 1957
Topics: Phenothiazines; Promazine; Schizophrenia
PubMed: 13394734
DOI: 10.1176/ajp.113.7.654 -
Polish Journal of Pharmacology 1996Combinations of neuroleptics and carbamazepine are administered to psychiatric patients in the therapy of mania, manic-depressive illness and schizophrenia. The present...
Combinations of neuroleptics and carbamazepine are administered to psychiatric patients in the therapy of mania, manic-depressive illness and schizophrenia. The present study was aimed at assessing the influence of carbamazepine on the pharmacokinetics of promazine. Male Wistar rats received promazine and/or carbamazepine twice daily for two weeks (promazine, 10 mg/kg ip; carbamazepine, 15 mg/kg ip during the 1st, and 20 mg/kg ip during the 2nd week of treatment). In a short time (1 h) after administration, carbamazepine had a tendency to increase the concentration of promazine in the blood plasma and brain. Lineweaver-Burk's analysis showed that carbamazepine added in vitro competitively inhibited the N-demethylation of promazine in liver microsomes, without affecting the sulphoxidation process. The effect was reflected in vivo (1 h) by an increased promazine/desmethylpromazine ratio. After a long time interval (6 h, 12 h), carbamazepine decreased the concentration of promazine and its metabolites. In vitro studies into the promazine metabolism, conducted on microsomes from rats treated with promazine and/or carbamazepine, did not show acceleration of its demethylation or sulphoxidation by carbamazepine. The obtained results suggest that induction of promazine metabolism by carbamazepine involves metabolic pathways other than N-demethylation or sulphoxidation. It has been concluded that when a phenothiazine neuroleptic, such as promazine, is administered jointly with carbamazepine, a slight increase in the neuroleptic concentration may be expected in a short time after administration, followed by its significant decrease.
Topics: Animals; Anticonvulsants; Antipsychotic Agents; Brain; Carbamazepine; Chromatography, High Pressure Liquid; Cytochrome P-450 Enzyme System; Cytochromes b5; Drug Interactions; Drug Synergism; In Vitro Techniques; Injections, Intraperitoneal; Male; Methylation; Microsomes, Liver; Promazine; Rats; Rats, Wistar
PubMed: 9112700
DOI: No ID Found -
Die Pharmazie 1980
Topics: Animals; Biotransformation; Male; Promazine; Rats
PubMed: 7413716
DOI: No ID Found