A controlled double blind study of zuclopenthixol acetate compared with clothiapine in acute psychosis including mania and exacerbation of chronic psychosis

Uys, H; Berk, Michael

doi:10.1016/0924-977x(96)87580-8

Cited by 8 publications

(18 citation statements)

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“…We included nine studies in the quantitative meta-analysis (Bahrain 1996: Canada 1994: China 1997: France 1988: Malaysia 1998: Nordic 1993: South Africa 1996: South Africa 1997: Thailand 2002).…”

Section: Resultsmentioning

confidence: 99%

Zuclopenthixol acetate for acute schizophrenia and similar serious mental illnesses

Jayakody

Gibson

Kumar

et al. 2012

Cochrane Database of Systematic Reviews

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Background Medication used for acute aggression in psychiatry must have rapid onset of effect, low frequency of administration and low levels of adverse effects. Zuclopenthixol acetate is said to have these properties. Objectives To estimate the clinical effects of zuclopenthixol acetate for the management of acute aggression or violence thought to be due to serious mental illnesses, in comparison to other drugs used to treat similar conditions. Search methods We searched the Cochrane Schizophrenia’s Group Trials Register (July 2011). We supplemented this by citation searching and personal contact with authors and relevant pharmaceutical companies. Selection criteria All randomised clinical trials involving people thought to have serious mental illnesses comparing zuclopenthixol acetate with other drugs. Data collection and analysis Two review authors extracted and cross-checked data independently. We calculated fixed-effect relative risks (RR) and 95% confidence intervals (CI) for dichotomous data. We analysed by intention-to-treat. We used mean differences (MD) for continuous variables. Main results We found no data for the primary outcome, tranquillisation. Compared with haloperidol, zuclopenthixol acetate was no more sedating at two hours (n = 40, 1 RCT, RR 0.60, 95% CI 0.27 to 1.34). People given zuclopenthixol acetate were not at reduced risk of being given supplementary antipsychotics (n = 134, 3 RCTs, RR 1.49, 95% CI 0.97 to 2.30) although additional use of benzodiazepines was less (n = 50, 1 RCT, RR 0.03, 95% CI 0.00 to 0.47). People given zuclopenthixol acetate had fewer injections over seven days compared with those allocated to haloperidol IM (n = 70, 1 RCT, RR 0.39, 95% CI 0.18 to 0.84, NNT 4, CI 3 to 14). We found no data on more episodes of aggression or harm to self or others. One trial (n = 148) reported no significant difference in adverse effects for people receiving zuclopenthixol acetate compared with those allocated haloperidol at one, three and six days (RR 0.74, 95% CI 0.43 to 1.27). Compared with haloperidol or clotiapine, people allocated zuclopenthixol did not seem to be at more risk of a range of movement disorders (< 20%). Three studies found no difference in the proportion of people getting blurred vision/dry mouth (n = 192, 2 RCTs, RR at 24 hours 0.90, 95% CI 0.48 to 1.70). Similarly, dizziness was equally infrequent for those allocated zuclopenthixol acetate compared with haloperidol (n = 192, 2 RCTs, RR at 24 hours 1.15, 95% CI 0.46 to 2.88). There was no difference between treatments for leaving the study before completion (n = 522, RR 0.85, 95% CI 0.31 to 2.31). One study reported no difference in adverse effects and outcome scores, when high dose (50-100 mg/injection) zuclopenthixol acetate was compared with low dose (25-50 mg/injection) zuclopenthixol acetate. Authors’ conclusions Recommendations on the use of zuclopenthixol acetate for the management of psychiatric emergencies in preference to ‘standard’ treatment have to be viewed with caution. Most of the small...

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Section: Resultsmentioning

confidence: 99%

Zuclopenthixol acetate for acute schizophrenia and similar serious mental illnesses

Jayakody

Gibson

Kumar

et al. 2012

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

show abstract

“…The onset and severity of EPS are usually dose related, and effects can generally be managed by dose reduction, treatment discontinuation and/or administration of antiparkisonism medications. In limited evidence from comparative studies in patients with acute psychotic illnesses [34,36], antiparkisonian medications were required by approximately the same proportion of clotiapine and chlorpromazine recipients (56 vs. 62 % [34]; RR 0.92; 95 % CI 0.57-1.47 [38]), and by fewer clotiapine than zuclopenthixol recipients (5 vs. 43 % [36]; RR 0.11; 95 % CI 0.02-0.80 [38]). • Orthostatic hypotension Risk may be increased in patients who are elderly, have a history of cardiovascular disease and/or are receiving concomitant antihypertensive medication (Table 1).…”

Section: Chronic Schizophreniamentioning

confidence: 99%

“…According to the overall findings of a meta-analysis [38] of relevant patients in five RCTs [33][34][35][36][37] that evaluated the efficacy of clotiapine in the treatment of acute psychotic illnesses using a variety of endpoints, the efficacy of clotiapine was broadly similar to that of other classic antipsychotics (i.e. chlorpromazine [34], perphenazine [33] and trifluorperazine [35]), as well as that of benzodiazepines (i.e.…”

Section: Acute Psychotic Illnessesmentioning

confidence: 99%

“…In the three RCTs that reported patient attrition data [34][35][36] (total n = 121), the proportions of patients who withdrew from treatment for any reason with clotiapine were comparable to those with chlorpromazine (26 vs. 19 %) [34], trifluorperazine (0 % in both groups) [35], and intramuscular zuclopenthixol acetate (19 vs. 0 %) [36]; overall, there was no significant difference between Table 1 General prescribing summary of clotiapine in schizophrenia. Consult local prescribing information [12][13][14][15][16][17][18][19] for further details…”

Section: Acute Psychotic Illnessesmentioning

confidence: 99%

“…Clotiapine has shown efficacy in the treatment of acute psychotic illnesses, including schizophrenia, in small double-blind RCTs conducted in the hospital setting [33][34][35][36][37]. According to the overall findings of a meta-analysis [38] of relevant patients in five RCTs [33][34][35][36][37] that evaluated the efficacy of clotiapine in the treatment of acute psychotic illnesses using a variety of endpoints, the efficacy of clotiapine was broadly similar to that of other classic antipsychotics (i.e.…”

Section: Acute Psychotic Illnessesmentioning

confidence: 99%

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