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Haloperidol versus chlorpromazine for schizophrenia.

C Leucht, M Kitzmantel, L Chua

The Cochrane Database of Systematic Reviews

|February 7, 2008

Summary

Haloperidol and chlorpromazine are standard antipsychotics for schizophrenia. Haloperidol led to fewer early study withdrawals, but caused more movement disorders, while chlorpromazine increased hypotension risk. More research is needed.

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Area of Science:

Psychiatry and Pharmacology
Clinical Trials and Evidence-Based Medicine

Background:

Chlorpromazine and haloperidol are established antipsychotic medications for schizophrenia.
While considered equally effective at equivalent doses, they possess distinct side-effect profiles.

Purpose of the Study:

To conduct a comparative analysis of haloperidol versus chlorpromazine in treating schizophrenia and schizophrenia-like psychoses.

Main Methods:

Systematic review of randomized controlled trials comparing haloperidol and chlorpromazine.
Data extraction and quality assessment by independent reviewers.
Statistical analysis using random-effects models for dichotomous and continuous outcomes.

Main Results:

14 studies (n=794) were included, mostly from the 1970s with poor reporting.
Haloperidol showed significantly fewer participants discontinuing treatment early (RR 0.26).
Haloperidol increased movement disorders (RR 2.2), while chlorpromazine was linked to more hypotension (RR 0.31).

Conclusions:

Despite being standard treatments, evidence comparing haloperidol and chlorpromazine is limited by study quality and reporting.
Haloperidol appears to cause more extrapyramidal side effects, whereas chlorpromazine is associated with higher rates of hypotension.
There is a need for large, well-designed, and rigorously reported studies to clarify comparative efficacy and safety.