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Pimozide for schizophrenia or related psychoses
1University of Leeds, Department of Psychiatry, 15 Hyde Terrace, Leeds, UK, LS2 9LT. jrathbone@cochrane-sz.org
The Cochrane Database of Systematic Reviews
|July 20, 2007
Summary
Pimozide, an antipsychotic, shows similar efficacy to other drugs for schizophrenia but increases tremor risk. It may prevent relapse but lacks data for delusional disorder treatment.
Area of Science:
- Psychiatry and Psychopharmacology
- Clinical Trial Analysis
- Evidence-Based Medicine
Background:
- Pimozide, an antipsychotic medication developed in the 1960s, is used for schizophrenia and delusional disorder.
- Associated cardiotoxicity and sudden deaths necessitate electrocardiogram monitoring during pimozide use.
Purpose of the Study:
- To evaluate the clinical effectiveness of pimozide in patients with schizophrenia, non-affective psychoses, and delusional disorder.
- To compare pimozide's efficacy and adverse effects against other antipsychotic treatments through a systematic review of randomized controlled trials.
Main Methods:
- Searched the Cochrane Schizophrenia Group's Register for relevant randomized clinical trials up to July 2005.
- Independently assessed study quality, extracted data, and performed intention-to-treat analyses for dichotomous and continuous outcomes.
- Calculated relative risks (RR), confidence intervals (CI), number needed to treat (NNT), and number needed to harm (NNH).
Main Results:
- Pimozide demonstrated efficacy in preventing relapse in schizophrenia patients (RR 0.45, NNT 4).
- Compared to typical antipsychotics, pimozide showed similar efficacy in global functioning, mental state, and relapse rates.
- Pimozide increased the risk of tremor (NNH 6) and need for antiparkinsonian medication (NNH 3) but reduced sedation in the medium-term.
Conclusions:
- Pimozide exhibits comparable efficacy to commonly used antipsychotics like chlorpromazine for schizophrenia, despite data limitations.
- No evidence supports or refutes pimozide's use in treating delusional disorder.
- The findings underscore the need for careful consideration of pimozide's risk-benefit profile in schizophrenia management.
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