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4.Cerebrovascular system

Neuroleptics produce hypotension (primarily postural) by a central as well as peripheral action on sympathetic tone, which is more marked after parenteral administration and roughly parallels the á-adrenergic blocking potency. This is not prominent in psychotic patients and is accentuated by hypovolemia. Partial tolerance develops after chro­nic use. Reflex tachicardia accompanies hypotension.

High doses of chlorpromazine directly depress the heart and produce ECG changes – QT prolongation and suppression of T wave. It exerts some antiarrhythmic action, probably due to membrane stabilization. Arrhythmia may occur in overdose, especially with thioridazine.