Chlorpromazine and Pecazine in Chronic Schizophrenia

The efficacy of chlorpromazine was compared with that of pecazine. A double-blind, controlled trial was carried out on 92 female patients, the whole schizophrenic population of under sixty years of age on three chronic psychiatric wards. The patients were divided into three groups and assessed every four weeks by a modification of the Albany Behavioural Rating Scale (Shatin and Freed, 1955). After eight weeks on the drugs, the group which had chlorpromazine was significantly better than the control group. The group which had pecazine was better than the control group, but not significantly so. A better method is to allow each patient to act as her own control. Analysed from this point of view, group A showed only slight improvement whilst receiving pecazine and chlorpromazine in turn. Significance was not approached. Group B showed improvement whilst on chlorpromazine, significance being approached after eight weeks on the drug. Improvement continued and significance was reached during the first four weeks on pecazine, immediately after the chlorpromazine, the group deteriorating once more during the final four weeks on pecazine. There was no significant change in the scores for mental tension or thought disorder during the investigation. The results with chlorpromazine are less impressive than those of most other workers. Only 7 out of 61 patients showed an improvement of over 3 points (out of a possible 18) whilst on chlorpromazine. It is suggested that phenothiazine derivatives are used too frequently with chronic schizophrenic patients. A case of agranulocytosis occurring with pecazine is described.