science
Drug Pair Cooled Patients Slightly but Did Not Cut Brain Damage in Small Stroke Trial
Promethazine and chlorpromazine lowered core body temperature and limited injury in mice and monkeys after induced strokes. A 32-person human trial showed only a 0.3 °C temperature drop and no reduction in damage. A follow-up trial will test faster infusions.
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A combination of promethazine and chlorpromazine reduced core body temperature, suppressed glucose metabolism and limited brain damage in mice and rhesus monkeys after induced strokes, @NewScientist reported. Treated monkeys also showed improved limb function compared with untreated animals. The same drugs produced a smaller effect in people.
In a trial of 32 patients who received the combination or placebo alongside standard clot-removal therapy, body temperature fell by 0.3 °C, or about 0.5 °F, but stroke damage was not reduced. Infusions were given over 12 hours. Shuaili Xu at Capital Medical University in Beijing said the slow delivery may have kept blood concentrations too low to achieve meaningful cooling.
His team has started a follow-up trial that will administer the drugs over one hour. Both medications have been used for decades. Promethazine treats hay fever and aids sleep; chlorpromazine is prescribed for schizophrenia and bipolar disorder.
Researchers have known since the 1950s that the drugs can lower body temperature without causing shivering. Kirsten Coupland at the University of Newcastle said the approach is worth pursuing because physical cooling methods have proved impractical. The study appeared in Science Translational Medicine.
