Antipsychotics are safer in the patient with

(B) Hypertension # CVS:> Neuroleptics produce hypotension (primarily postural) by a central as well as peripheral action on sympathetic tone.> Chlorpromazine lowers seizure threshold and can precipitate fits in untreated epileptics.> The piperazine side chain compounds have a lower propensity for this action.# Endocrine:> They reduce gonadotropin secretion but amenorrhoea and infertility occur only occasionally.> ACTH release in response to stress is diminished -- corticosteroid levels fail to increase under such circumstances.> Release of GH is also reduced but this is not sufficient to cause growth retardation in children or to be beneficial in acromegaly.