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May 13, 1974

Estrogen Effects on Phenothiazine Derivative Blood Levels

Author Affiliations

Tennessee Neuropsychiatrie Institute Nashville, Tenn

JAMA. 1974;228(7):827-828. doi:10.1001/jama.1974.03230320015012

To the Editor.—  A patient having "morning sickness" developed a dystonic reaction with a single dose of prochlorperazine (Compazine). Estrogens are reportedly increased during that time of pregnancy, and their possible influence on such a reaction was entertained. Utilizing a dependable and sensitive fluorometric method for the assay of plasma butaperazine,1 the effects of conjugated estrogens on plasma levels of this phenothiazine derivative were studied. Four postmenopausal female schizophrenic patients, having normal blood chemistry (automated multiple analysis system), thyroid, and liver function tests, and following a week on no medication, were randomly assigned to either a seven-day "control period" of receiving no hormone, or an "experimental period" of receiving conjugated estrogens (Premarin), 1.25 mg daily, with a crossover design that used subjects as their own controls. On the seventh day of each period, a single oral dose of 40 mg of butaperazine was given to subjects who had fasted