Cochrane · systematic review · CD007778
Chlorpromazine dose for people with schizophrenia
Dudley, K, Liu, X, De Haan, S · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
14
current version
GRADE rated
11
No studies
1
Included studies
NR
No studies 1 · 7.1%Ungraded 2 · 14.3%Very low 3 · 21.4%Low 2 · 14.3%Moderate 6 · 42.9%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyCHLORPROMAZINE LOW DOSE (≤ 400 mg/day) compared to MEDIUM DOSE (401 mg/day to 800 mg/day) for people with schizophrenia
Population: people with schizophrenia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Global state: no improvement ‐ short term CHLORPROMAZINE LOW DOSE (≤ 400 mg/day) vs MEDIUM DOSE (401 mg/day to 800 mg/day) | RR 0.83 [0.28, 2.44] | 1 study · 60 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Global state: needing additional medication (sedation with chloral hydrate or a barbiturate > 5 times) ‐ medium term CHLORPROMAZINE LOW DOSE (≤ 400 mg/day) vs MEDIUM DOSE (401 mg/day to 800 mg/day) | RR 3.09 [0.4, 23.64] | 1 study · 50 participants | Low Downgraded: risk of bias, imprecision |
Mental state: average endpoint score (PANSS total, high=poor) CHLORPROMAZINE LOW DOSE (≤ 400 mg/day) vs MEDIUM DOSE (401 mg/day to 800 mg/day) | no estimate extracted | 1 study · 60 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Leaving the study early ‐ any reason CHLORPROMAZINE LOW DOSE (≤ 400 mg/day) vs MEDIUM DOSE (401 mg/day to 800 mg/day) | RR 1.06 [0.32, 3.55] | 2 studies · 70 participants | Moderate Downgraded: risk of bias |
Behaviour: agitation and restlessness ‐ medium term (categorised as adverse event) CHLORPROMAZINE LOW DOSE (≤ 400 mg/day) vs MEDIUM DOSE (401 mg/day to 800 mg/day) | RR 1.59 [0.07, 37.03] | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse effects: extrapyramidal symptoms (unspecified extrapyramidal symptoms ‐ short term) CHLORPROMAZINE LOW DOSE (≤ 400 mg/day) vs MEDIUM DOSE (401 mg/day to 800 mg/day) | RR 0.47 [0.3, 0.74] | 2 studies · 108 participants | Moderate Downgraded: risk of bias |
Adverse event: death CHLORPROMAZINE LOW DOSE (≤ 400 mg/day) vs MEDIUM DOSE (401 mg/day to 800 mg/day) | no estimate extracted | NR | No studies |
CHLORPROMAZINE LOW DOSE (≤ 400 mg/day) compared to HIGH DOSE (> 800 mg/day ‐ all medium term) for people with schizophrenia
Population: patients with people with schizophrenia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Global state: no clinically important improvement ‐ medium term CHLORPROMAZINE LOW DOSE (≤ 400 mg/day) vs HIGH DOSE (> 800 mg/day ‐ all medium term) | RR 1.13 [1.01, 1.25] | 1 study · 416 participants | Moderate Downgraded: risk of bias |
Global state: requiring additional medication (sedation with chloral hydrate or a barbiturate > 5 times) CHLORPROMAZINE LOW DOSE (≤ 400 mg/day) vs HIGH DOSE (> 800 mg/day ‐ all medium term) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Mental state: no clinically important change in mental state CHLORPROMAZINE LOW DOSE (≤ 400 mg/day) vs HIGH DOSE (> 800 mg/day ‐ all medium term) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Leaving the study early ‐ any reason CHLORPROMAZINE LOW DOSE (≤ 400 mg/day) vs HIGH DOSE (> 800 mg/day ‐ all medium term) | RR 0.6 [0.4, 0.89] | 1 study · 416 participants | Moderate Downgraded: risk of bias |
Behaviour: deterioration of behaviour (categorised as reason to leave early) CHLORPROMAZINE LOW DOSE (≤ 400 mg/day) vs HIGH DOSE (> 800 mg/day ‐ all medium term) | RR 2.7 [1.34, 5.44] | 1 study · 416 participants | Low Downgraded: risk of bias |
Adverse effects: unspecified extrapyramidal symptoms CHLORPROMAZINE LOW DOSE (≤ 400 mg/day) vs HIGH DOSE (> 800 mg/day ‐ all medium term) | RR 0.43 [0.32, 0.59] | 1 study · 416 participants | Moderate Downgraded: risk of bias |
Adverse event: death CHLORPROMAZINE LOW DOSE (≤ 400 mg/day) vs HIGH DOSE (> 800 mg/day ‐ all medium term) | RR 0.33 [0.01, 8.14] | 1 study · 416 participants | Moderate Downgraded: risk of bias |
Summary of findings ‐ low dose vs medium dose
Population: patients with people with schizophrenia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Adverse effects: Movement disorder ‐ akathisia Simpson and Angus ( Summary of findings ‐ low dose vs medium dose | RR 1.63 [0.34, 7.76] | 2 studies · 70 participants | Very low |
Adverse effects: Movement disorder ‐ dystonia Simpson and Angus ( Summary of findings ‐ low dose vs medium dose | RR 0.2 [0.04, 0.97] | 2 studies · 70 participants | Very low |
Summary of findings ‐ low dose vs high dose
Population: patients with people with schizophrenia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Global state: Not improved or severely ill ‐ no clinically important improvement GIS, GSIS, GAS1 ( Summary of findings ‐ low dose vs high dose | RR 1.12 [1.01, 1.23] | 1 study · 416 participants | Low Downgraded: risk of bias |
Adverse effects: Movement disorders ‐ akathisia No specific scale ( Summary of findings ‐ low dose vs high dose | RR 1 [0.55, 1.83] | 1 study · 416 participants | Low Downgraded: risk of bias |
Adverse effects: Movement disorders ‐ dystonia No specific scale ( Summary of findings ‐ low dose vs high dose | RR 0.11 [0.02, 0.45] | 1 study · 416 participants | Low Downgraded: risk of bias |