Quantitative comparison of clinical effectiveness of chlorpromazine and promazine

A double-blind study of chlorpromazine and promazine was conducted to measure their comparative therapeutic effectiveness on a short-term basis at medium dosage levels, such as might be used for out-patient purposes. The patients chosen, however, represented a more therapeutically challenging group of hospitalized acute schizophrenics in whom a dramatic and convincing effect might offer an evaluation of comparative response.

A clinical trial comparing prochlorperazine (stemetil) with chlorpromazine (largactil) in the treatment of chronic psychotic patients

Chlorpromazine (“Largactil”) was introduced to this country some five years ago, and since that time a considerable number of reports on its clinical efficacy have appeared, including Anton-Stephens (1954) and Garmany et al. (1954). There is now general agreement that it is a useful form of treatment in chronic schizophrenia, especially for the aggressive, disturbed patient (Salisbury and Hare, 1957). More recently another phenothiazine derivative, incorporating a piperazine ring in the side chain, has been produced.

Physical treatment for schizophrenia

In spite of the enthusiasm with which schizophrenic patients have been treated by physical methods over the past twenty years, there is surprisingly little evidence enabling us to compare the results of one physical treatment with another, or the physical treatments themselves with the treatments they replaced. Some writers (Polonio and Slater, 1954; Rees, 1949) point out a significant improvement over the spontaneous recovery rate with the use of insulin, while others (Jensen, 1952) find no such improvement. Bourne (1953) and Notkin et al. (1939) go so far as to claim that any improvements of insulin-treated patients are due to the extra care and attention they receive, and the work of Ackner and his colleagues (1957) may support this conclusion. Linford Rees (1949) comparing electrical treatment with insulin concluded that electro-shock therapy was far less effective than deep insulin therapy in the treatment of schizophrenia—a conclusion in line with that of Finiefs (1948). On the other hand Impastato and Almansi found very little difference between E.C.T. and insulin treatment in this respect.

The effects of physical treatment on some psychological functions

It is not only the directly observable therapeutic effects of treatment which will determine the value of that treatment—in many cases the accompanying side effects are equally, if not more important, depending upon their nature and severity.