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At Brooklyn's Maimonides Hospital, Drs. Charles E. Friedgood and Charles B. Ripstein have found chlorpromazine similarly effective in banishing the agonizing symptoms of withdrawal from narcotics (morphine and Demerol) and barbiturates. In Chicago, Police Surgeon Eugene F. Carey gives reserpine to narcotics addicts who are forced to "kick the habit," i.e., give up narcotics abruptly, during detention before they are sent on to court and hospitals. It saves them, he reports, from the usual weeping, nausea, retching, chills and shakes.
The psychoneuroses are generally considered milder mental illnesses than the psychoses, but some of them can be as stubbornly difficult to treat. The results from chlorpromazine and reserpine in these cases have been spotty. Among the brilliant successes is one reported from Ohio's Longview State Hospital by Dr. Goldman, concerning a young woman who was a mysophobe, i.e., a compulsive hand-washer. For years she had washed her hands 30 to 40 times a day, would not touch a doorknob with her bare hands. After four months on chlorpromazine she told the psychiatrist that her ideas about dirt had been foolish, and she had got over them.
In a similar class are many cases of chronic hiccuping. The drugs have arrested some of these. They are also exremely effective against nausea and vomting during pregnancy, or resulting from some forms of cancer, or from radiation and chemical treatments given to check cancer. The drugs seem to have no direct effect on the pain of cancer, but they make patients easier by removing their anxiety about the pain.
Tke Dangers. Both chlorpromazine and reserpine have marked and undesirable side effects which make them potentially dangerous in the haphazard use which some general practitioners and office psychiatrists are now making of them. Early in treatment, both cause a drop in blood pressure which may make the patient faint if he stands up suddenly. Some individuals have an allergic reaction to the drugs. About one in 20, especially on reserpine, may develop symptoms which look like Parkinson's disease (tremor, stooped posture, masklike face, inability to raise the arms except in jerks). All these disagreeable symptoms usually disappear quickly after the drug is withdrawn, and in many cases the same patients can start taking it again soon, without recurrence of the trouble.
More serious side effects are a form of jaundice that appears in from 1% to 5% of patients on chlorpromazine, and agranulocytosis, in which certain white blood cells disappear and the throat and digestive tract become ulcerated. There have been four confirmed cases of agranulocytosis, with one death. But doctors feel that even this risk is justified, provided the patients are watched closely, because with modern antibiotics the disease can nearly always be cured.