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December 1963

Massive Doses of Chlorpromazine: Effectiveness in Controlling Psychotic Behavior

Author Affiliations

Resident in Psychiatry, Massachusetts Mental Health Center, and Teaching Fellow in Psychiatry, Harvard Medical School.

Arch Gen Psychiatry. 1963;9(6):586-592. doi:10.1001/archpsyc.1963.01720180058008

I. Introduction

In the decade since its introduction into clinical psychiatry, chlorpromazine has become established as a major modality in the treatment of psychoses. Although the major parameters of its clinical use are agreed upon, matters of dosage are still uncertain, particularly the value of high dose schedules. One feature of its clinical pharmacology which contributes to its usefulness is the relatively wide range of safety. While most investigators report prescribing daily dosages of 300 to 800 mg in schizophrenia, some have used as much as 5,000 mg daily. The amount an individual prescribed is highly variable, limited by clinical effectiveness or the appearance of toxic signs.

At the Massachusetts Mental Health Center (formerly Boston Psychopathic Hospital) over a two-year period, one in every 12 patients treated with chlorpromazine received 1,500 mg or more daily at some time during their hospitalization. Because such

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