The pharmacology of chlorpromazine (Anton-Stephens, 1954; Hopkin, 1955) and its use in psychiatric practice (Garmany et al., 1954; Elkes et al., 1954; Charatan, 1954; Labhardt, 1954) have been described in several recent papers. The present paper briefly describes a controlled experiment on the use of the drug in a group of chronic disturbed schizophrenic patients, the object being to introduce as few variables as possible into the experimental situation, with a view to making the results as objective as is ever possible in a psychiatric investigation.
Seven drugs of the imino-dibenzyl group are now generally available in Great Britain (imipramine, amitriptyline, desipramine, nortriptyline, protriptyline, trimipramine and opipramol). All are similar in their actions and side-effects. Imipramine, the first to appear, has been shown to be more effective than placebo in the treatment of depression, though with much better results in men than in women (M.R.C. Clinical Trial, 1965). Desipramine, a metabolite of impramine, was introduced with the claim that its action was quicker than that of imipramine, though this has never been clearly demonstrated. Trials of desipramine against imipramine (Waldron and Bates, 1965; Rose and Westhead, 1964) showed no significant difference between these drugs. Comparison of amitriptyline and imipramine (Burt, Gordon, Holt and Hordern, 1962), showed amitriptyline to be at least as effective as imipramine and significantly superior in the treatment of endogenous depression. Comparisons of nortriptyline and amitriptyline (Forrest, Affleck, Gibb and Priest, 1964; Rose, Leahy, Martin and Westhead, 1965) showed no significant difference between these drugs.
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