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Thioridazine for schizophrenia.

M Fenton, J Rathbone, J Reilly

    The Cochrane Database of Systematic Reviews
    |July 20, 2007
    PubMed
    Summary
    This summary is machine-generated.

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    Thioridazine is an effective antipsychotic for schizophrenia, comparable to other treatments. However, it carries risks of sedation and cardiac issues, necessitating careful monitoring.

    Area of Science:

    • Psychiatry and Pharmacology
    • Clinical Trials and Evidence-Based Medicine

    Background:

    • Thioridazine is an antipsychotic medication used for schizophrenia.
    • It is associated with a risk of cardiac arrhythmia, specifically torsades de pointe.

    Purpose of the Study:

    • To conduct a systematic review of randomized clinical trials evaluating the efficacy and safety of thioridazine in patients with schizophrenia.
    • To update previous reviews with the latest available evidence.

    Main Methods:

    • Searched the Cochrane Schizophrenia Group's Register for relevant studies up to June 2006.
    • Included randomized clinical trials comparing thioridazine with placebo, typical antipsychotics, or atypical antipsychotics.
    • Extracted and analyzed dichotomous data using relative risks (RR) and confidence intervals (CI), calculating number needed to treat/harm (NNT/H) where applicable.

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    Main Results:

    • Thioridazine showed benefits in global state outcomes compared to placebo (RR 0.33, NNT 2).
    • It is associated with sedation (RR 5.37, NNH 4) and increased risk of cardiac adverse events (RR 3.17, NNH 3) and ECG changes (RR 2.38, NNH 4).
    • Compared to typical antipsychotics, thioridazine demonstrated similar efficacy in global state and reduced extrapyramidal adverse events (RR 0.45).

    Conclusions:

    • Thioridazine is an antipsychotic with efficacy comparable to other commonly used medications for schizophrenia.
    • While it may have fewer extrapyramidal side effects, it carries a higher risk of cardiac adverse events and ECG changes.
    • Alternative medications are recommended; however, if thioridazine use is unavoidable, cardiac monitoring is advised.