Perphenazine for schizophrenia

Hartung, Benno; Wada, Makoto; Laux, Gerd; Leucht, Stefan

doi:10.1002/14651858.cd003443.pub2

Cited by 21 publications

(13 citation statements)

References 82 publications

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“…The network could be expanded to old drugs such as perphenazine and sulpiride, which have had good results in effectiveness studies, 55,56 but only a few relevant perphenazine trials have been done. 57 As more and more second-generation antipsychotics are losing their patent protection, the debate about the costs of the original second-generation antipsychotics becomes less important. The present debate is about whether …”

Section: Focusmentioning

confidence: 99%

Comparative Efficacy and Tolerability of 15 Antipsychotic Drugs in Schizophrenia: A Multiple-Treatments Meta-Analysis

Leucht

Cipriani

Spineli

et al. 2014

FOC

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329

503

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Background: The question of which antipsychotic drug should be preferred for the treatment of schizophrenia is controversial, and conventional pairwise meta-analyses cannot provide a hierarchy based on the randomised evidence.We aimed to integrate the available evidence to create hierarchies of the comparative efficacy, risk of all-cause discontinuation, and major side-effects of antipsychotic drugs. Methods: We did a Bayesian-framework, multipletreatments meta-analysis (which uses both direct and indirect comparisons) of randomised controlled trials to compare 15 antipsychotic drugs and placebo in the acute treatment of schizophrenia. We searched the Cochrane Schizophrenia Group's specialised register, Medline, Embase, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov for reports published up to Sept 1, 2012. Search results were supplemented by reports from the US Food and Drug Administration website and by data requested from pharmaceutical companies. Blinded, randomised controlled trials of patients with schizophrenia or related disorders were eligible. We excluded trials done in patients with predominant negative symptoms, concomitant medical illness, or treatment resistance, and those done in stable patients. Data for seven outcomes were independently extracted by two reviewers. The primary outcome was efficacy, as measured by mean overall change in symptoms. We also examined all-cause discontinuation, weight gain, extrapyramidal side-effects, prolactin increase, QTc prolongation, and sedation. Findings: We identified 212 suitable trials, with data for 43 049 participants. All drugs were significantly more effective than placebo. The standardised mean differences with 95% credible intervals were: clozapine 0·88, 0·73-1·03; amisulpride 0·66, 0·53-0·78; olanzapine 0·59, 0·53-0·65; risperidone 0·56, 0·50-0·63; paliperidone 0·50, 0·39-0·60; zotepine 0·49, 0·31-0·66; haloperidol 0·45, 0·39-0·51; quetiapine 0·44, 0·35-0·52; aripiprazole 0·43, 0·34-0·52; sertindole 0·39, 0·26-0·52; ziprasidone 0·39, 0·30-0·49; chlorpromazine 0·38, 0·23-0·54; asenapine 0·38, 0·25-0·51; lurasidone 0·33, 0·21-0·45; and iloperidone 0·33, 0·22-0·43. Odds ratios compared with placebo for all-cause discontinuation ranged from 0·43 for the best drug (amisulpride) to 0·80 for the worst drug (haloperidol); for extrapyramidal side-effects 0·30 (clozapine) to 4·76 (haloperidol); and for sedation 1·42 (amisulpride) to 8·82 (clozapine). Standardised mean differences compared with placebo for weight gain varied from 20·09 for the best drug (haloperidol) to 20·74 for the worst drug (olanzapine), for prolactin increase 0·22 (aripiprazole) to 21·30 192 (paliperidone), and for QTc prolongation 0·10 (lurasidone) to 20·90 (sertindole). Efficacy outcomes did not change substantially after removal of placebo or haloperidol groups, or when dose, percentage of withdrawals, extent of blinding, pharmaceutical industry sponsorship, study duration, chronicity, and year of publication were accounted for in metaregressions and sensitivit...

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Section: Focusmentioning

confidence: 99%

Comparative Efficacy and Tolerability of 15 Antipsychotic Drugs in Schizophrenia: A Multiple-Treatments Meta-Analysis

Leucht

Cipriani

Spineli

et al. 2014

FOC

Self Cite

329

503

View full text Add to dashboard Cite

show abstract

“…Although often stated as being of comparable potency to haloperidol (Hartung 2005), perphenazine is best considered as of intermediate potency. Based on animal data, the originally suggested chlorpromazine:perphenazine potency of 5:1 or 6:1 (Rees 1960) would now seem an underestimate, with clinical potency best considered at about 10-15 times that of chlorpromazine (chlorpromazine:perphenazine = 100:8 mg), as some estimated from the start (DiMascio 1963a).…”

Section: Perphenazine (Table 4)mentioning

confidence: 99%

Meet the relatives: a reintroduction to the clinical pharmacology of ‘typical’ antipsychotics (Part 1)

Owens

2012

Adv. psychiatr. treat

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SummaryA number of pragmatic trials have cast doubt on the concept of ‘atypicality’ in relation to antipsychotic drugs, and some commentators have argued that the dichotomy between ‘typical’ (‘first-generation’) and ‘atypical’ ('second-generation’) compounds is artificial and should be abandoned, leaving the entire class of antipsychotics available for consideration in more individualised treatment planning. However, younger psychiatrists now gain little or no experience in the use of older antipsychotics. This is the first of two articles addressing practical issues for consideration in prescribing the older antipsychotics available in the UK. It covers background, including the fundamental clinical action of antipsychotics, the nature of drug licensing and identification of pharmacological parameters that may be of value in prescribing decisions, and discusses the phenothiazines: chlorpromazine, promazine, levomepromazine, pericyazine, perphenazine, trifluoperazine and prochlorperazine.

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“…While tobacco cessation quit lines and worksite-sponsored programs that incorporate guideline-based treatment approaches are both effective and easily accessible, their public health impact is limited by under-utilization. (2)…”

Section: Introductionmentioning

confidence: 99%

Helpers Program

Murãmoto

Wassum²,

Connolly

et al. 2010

American Journal of Preventive Medicine

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Background Quitlines and worksite-sponsored cessation programs are effective and highly accessible, but limited by low utilization. Efforts to encourage use of cessation aids have focused almost exclusively on the smoker, overlooking the potential for friends, family, coworkers and others in a tobacco user’s social network to influence quitting and use of effective treatment. Methods Longitudinal, observational pilot feasibility study with six-week follow-up survey. Setting/Participants Employees of three national corporations, with a combined target audience of 102,100 employees. Intervention The Helpers Program offers Web-based brief intervention (BI) training to activate social networks of tobacco users to encourage quitting and use of effective treatment. Helpers was offered from 1/10/08 to 3/31/08, as a treatment engagement strategy, together with Free and Clear’s (F&C) telephone/Web-based cessation services. Main outcome measures web-site utilization, training completion, post-training changes in knowledge and self-efficacy with delivery of BIs, referrals to F&C, and use of BI training. Results There were 19,109 unique visitors to the Helpers Web-site. Of these, 4727 created user accounts; 1427 registered for Helpers Training; 766 completed training. There were 445 visits to the referral page and 201 e-mail or letter referrals generated. There were 67 requests for technical support. Of follow-up survey respondents (n=289), 78.9% reported offering a BI. Conclusions Offering the Helpers Program Web-site to a large, diverse audience as part of an employer-sponsored worksite health promotion program is both feasible and well accepted by employees. Website users will participate in training, encourage quitting, and refer smokers to quitline services.

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Perphenazine for schizophrenia

Cited by 21 publications

References 82 publications

Comparative Efficacy and Tolerability of 15 Antipsychotic Drugs in Schizophrenia: A Multiple-Treatments Meta-Analysis

Comparative Efficacy and Tolerability of 15 Antipsychotic Drugs in Schizophrenia: A Multiple-Treatments Meta-Analysis

Meet the relatives: a reintroduction to the clinical pharmacology of ‘typical’ antipsychotics (Part 1)

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