Monday, 10 February 2014

Perazine for schizophrenia

Schizophrenia is often a severe and disabling illness that affects approximately one per cent of the worldwide population. Schizophrenia has 'positive' symptoms, such as strange and fixed beliefs (delusions), as well as hearing voices and seeing things (hallucinations). Schizophrenia also has 'negative' symptoms such as apathy, loss of emotion, lack of drive and disorganisation of behaviour and thought. The degree of disability is considerable with 80% - 90% not working and up to 10% dying.

Antipsychotic drugs are the main treatment for schizophrenia, and are grouped into older drugs (first generation or ‘typical’) and newer drugs (second generation or ‘atypical’). However, antipsychotic drugs also have serious side effects, particularly movement disorders such as uncontrollable shaking, tremors, muscle stiffness, tiredness, weight gain and the inability to sit still.

Perazine is an older antipsychotic drug first introduced in the 1950s. It is suggested to have a low level of side effects (especially for movement disorders). Its use is regional and restricted to countries like Germany, Poland, the Netherlands and the former Yugoslavia.

A search for trials was carried out in July 2012. The review now includes seven studies with a total of 479 participants and assesses the effects of perazine for people with schizophrenia. Comparisons of perazine versus placebo (‘dummy’ treatment) and versus other antipsychotic drugs revealed no clear differences or superiority of perazine. However, only a handful of studies have been undertaken and the number of participants in each study was small. In addition the studies avialable were of limited quality with data for the main outcomes of interest rated as low or very low quality. As perazine is a cheap drug and there is some limited evidence that it may cause less side effects than other older antipsychotic drugs, further large scale, well designed and well-reported studies are much needed.


  1. Neuroscience/Psychiatry/Mental Health is like many other research domains in that most of what we want to know we either don't know or are not sure of. There are many barriers to implementing clinical research trials; funding, regulatory red tape, cultural inertia within medical organisations, etc. One of the principal barriers is the lack of awareness of the importance of research amongst the clinical care work force. Ben Gray's blog highlights the need for research and the need for both clinicians and the public as well as academics and associated financial and regulatory bodies to support it.