DEPRESSED PITUITARY-ADRENAL RESPONSE TO SURGICAL STRESS IN CHRONIC-SCHIZOPHRENIC PATIENTS

We evaluated whether pituitary-adrenal response to surgical stress is modified in chronic schizophrenic patients. Twenty-two schizophrenic p atients on chronic antipsychotic therapy of phenothiazine derivatives over 10 years underwent orthopedic surgery of the extremities under ge neral anesthesia by isoflurane and nitrous oxide. In chronic schizophr enic patients, responses of plasma epinephrine, norepinephrine, ACTH a nd cortisol levels during surgical stress were significantly lower tha n those of control patients. The attenuated response to surgical stres s in these patients may be associated with their autonomic dysfunction and decreased pituitary-adrenal activity due to chronic administratio n of antipsychotic agents.