Zuclopenthixol for acute schizophrenia

Zuclopenthixol might possibly be effective in controlling aggressive acute psychosis, although the evidence is insufficient. The effect might possibly be similar to intramuscular haloperidol, and the onset of action is not particularly rapid.

A Cochrane review included 9 studies. There was no data for the primary outcome, tranquilisation. Compared with haloperidol, zuclopenthixol acetate was no more sedating at two hours (RR 0.60 CI 0.27 to 1.34; 1 RCT, n=40). People given zuclopenthixol acetate were not at reduced risk of being given supplementary antipsychotics (RR 1.49 CI 0.97 to 2.30; 3 RCTs, n=134) although there was less additional use of benzodiazepines (RR 0.03 CI 0.00 to 0.47, NNT 2 CI 2 to 4; 1 RCT, n=50). People given zuclopenthixol acetate had fewer injections over seven days compared with those allocated to haloperidol IM (RR 0.39 CI 0.18 to 0.84, NNT 4 CI 3 to 14; 1 RCT, n=70). The risk of adverse effects (e.g., movement disorders, blurred vision, dry mouth, dizziness) is similar to haloperidol.

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment), indirectness (no data for the primary outcome) and imprecise results (limited study size for each comparison).

Ədəbiyyat

1. Jayakody K, Gibson RC, Kumar A et al. Zuclopenthixol acetate for acute schizophrenia and similar serious mental illnesses. Cochrane Database Syst Rev 2012;4():CD000525.