Chlorpromazine versus placebo for schizophrenia

Abstract

Background Chlorpromazine, formulated in the 1950s, remains a benchmark treatment for people with schizophrenia. Objectives To review the effects of chlorpromazine compared with placebo, for the treatment of schizophrenia. Search methods We searched the Cochrane Schizophrenia Group's Trials Register (15 May 2012). We also searched references of all identified studies for further trial citations. We contacted pharmaceutical companies and authors of trials for additional information. Selection criteria We included all randomised controlled trials (RCTs) comparing chlorpromazine with placebo for people with schizophrenia and nonaffective serious/chronic mental illness irrespective of mode of diagnosis. Primary outcomes of interest were death, violent behaviours, overall improvement, relapse and satisfaction with care. Data collection and analysis We independently inspected citations and abstracts, ordered papers, re-inspected and quality assessed these. We analysed dichotomous data using risk ratio (RR) and estimated the 95% confidence interval (CI) around this. We excluded continuous data if more than 50% of participants were lost to follow-up. Where continuous data were included, we analysed this data using mean difference (MD) with a 95% confidence interval. We used a fixed-effect model. Main results We inspected over 1100 electronic records. The review currently includes 315 excluded studies and 55 included studies. The quality of the evidence is very low. We found chlorpromazine reduced the number of participants experiencing a relapse compared with placebo during six months to two years follow-up (n=512, 3 RCTs, RR 0.65 CI 0.47 to 0.90), but data were heterogeneous. No difference was found in relapse rates in the short, medium or long term over two years, although data were also heterogeneous. We found chlorpromazine provided a global improvement in a person's symptoms and functioning (n=1164, 14 RCTs, RR 0.71 CI 0.58 to 0.86). Fewer people allocated to chlorpromazine left trials early (n=1831, 27 RCTs, RR 0.64 CI 0.53 to 0.78) compared with placebo. There are many adverse effects. Chlorpromazine is clearly sedating (n=1627, 23 RCTs, RR 2.79 CI 2.25 to 3.45), it increases 1 Chlorpromazine versus placebo for schizophrenia (Review)

Olanzapine Versus Chlorpromazine in the Treatment of Schizophrenia

“…27 The adverse events of hypotension and tremor were reported both in chlorpromazine-treated patients in our study and in the Cochrane review of chlorpromazine compared with placebo. 3 Our findings regarding weight gain among olanzapinetreated patients are consistent with the known safety profile of olanzapine and confirm the findings of previous studies. According to a review of antipsychotic-induced weight gain, 28 mean weight gain among olanzapine-treated patients was 4.15 kg after 10 weeks of treatment (compared with 3.41 kg in our 6-week study).…”

Olanzapine Versus Chlorpromazine in the Treatment of Schizophrenia

“…27 The adverse events of hypotension and tremor were reported both in chlorpromazine-treated patients in our study and in the Cochrane review of chlorpromazine compared with placebo. 3 Our findings regarding weight gain among olanzapinetreated patients are consistent with the known safety profile of olanzapine and confirm the findings of previous studies. According to a review of antipsychotic-induced weight gain, 28 mean weight gain among olanzapine-treated patients was 4.15 kg after 10 weeks of treatment (compared with 3.41 kg in our 6-week study).…”

Histological effects of pre-exposure prophylactic consumption of sulfa drugs on Liver and Kidney of albino Wister rats (Rattus novergicus).

“…The weight gain reported by [18] was observed in animals in the control groups. The low dose treatment animals show a negligible weight loss while the high dose treatment animals showed an appreciable loss in weight.…”

Definitions and drivers of relapse in patients with schizophrenia: a systematic literature review

“…The antipsychotic medication category does not include the other pharmacological therapy factors. Non-pharmacological therapies [4-6,11,14-16,27,32,41,42,64],[82,84,92,118-121]; antipsychotic medication [4,6,23,54,81,122-127]; risperidone/risperidone long-acting injectable (RLAI) specifically [22-24,35,65,74,128-131]; medication compliance [25,33,132,133]; Information Technology Aided Relapse Prevention in Schizophrenia (ITAREPS) [52]; good patient insight [134]; early detection [135]; greater frequency of electroconvulsive therapy (ECT) [90]; olanzapine specifically [21]. …”

Olanzapine Versus Chlorpromazine in the Treatment of Schizophrenia

“…27 The adverse events of hypotension and tremor were reported both in chlorpromazine-treated patients in our study and in the Cochrane review of chlorpromazine compared with placebo. 3 Our findings regarding weight gain among olanzapinetreated patients are consistent with the known safety profile of olanzapine and confirm the findings of previous studies. According to a review of antipsychotic-induced weight gain, 28 mean weight gain among olanzapine-treated patients was 4.15 kg after 10 weeks of treatment (compared with 3.41 kg in our 6-week study).…”

Histological effects of pre-exposure prophylactic consumption of sulfa drugs on Liver and Kidney of albino Wister rats (Rattus novergicus).

“…The weight gain reported by [18] was observed in animals in the control groups. The low dose treatment animals show a negligible weight loss while the high dose treatment animals showed an appreciable loss in weight.…”

Definitions and drivers of relapse in patients with schizophrenia: a systematic literature review

“…The antipsychotic medication category does not include the other pharmacological therapy factors. Non-pharmacological therapies [4-6,11,14-16,27,32,41,42,64],[82,84,92,118-121]; antipsychotic medication [4,6,23,54,81,122-127]; risperidone/risperidone long-acting injectable (RLAI) specifically [22-24,35,65,74,128-131]; medication compliance [25,33,132,133]; Information Technology Aided Relapse Prevention in Schizophrenia (ITAREPS) [52]; good patient insight [134]; early detection [135]; greater frequency of electroconvulsive therapy (ECT) [90]; olanzapine specifically [21]. …”

Olanzapine Versus Chlorpromazine in the Treatment of Schizophrenia

“…27 The adverse events of hypotension and tremor were reported both in chlorpromazine-treated patients in our study and in the Cochrane review of chlorpromazine compared with placebo. 3 Our findings regarding weight gain among olanzapinetreated patients are consistent with the known safety profile of olanzapine and confirm the findings of previous studies. According to a review of antipsychotic-induced weight gain, 28 mean weight gain among olanzapine-treated patients was 4.15 kg after 10 weeks of treatment (compared with 3.41 kg in our 6-week study).…”

Histological effects of pre-exposure prophylactic consumption of sulfa drugs on Liver and Kidney of albino Wister rats (Rattus novergicus).

“…The weight gain reported by [18] was observed in animals in the control groups. The low dose treatment animals show a negligible weight loss while the high dose treatment animals showed an appreciable loss in weight.…”

Definitions and drivers of relapse in patients with schizophrenia: a systematic literature review

“…The antipsychotic medication category does not include the other pharmacological therapy factors. Non-pharmacological therapies [4-6,11,14-16,27,32,41,42,64],[82,84,92,118-121]; antipsychotic medication [4,6,23,54,81,122-127]; risperidone/risperidone long-acting injectable (RLAI) specifically [22-24,35,65,74,128-131]; medication compliance [25,33,132,133]; Information Technology Aided Relapse Prevention in Schizophrenia (ITAREPS) [52]; good patient insight [134]; early detection [135]; greater frequency of electroconvulsive therapy (ECT) [90]; olanzapine specifically [21]. …”