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Evidence summaries

Thioridazine for Schizophrenia

Thioridazine is an antipsychotic of similar efficacy to other commonly used neuroleptics for people with schizophrenia, and it may have a lower level of extrapyramidal problems, but it is associated with the cardiac arrhythmia, torsades de pointe. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 42 studies with a total of 3 498 subjects. 27 studies (n=2 598) compared thioridazine with typical antipsychotics. For the outcome no better or worse the RR for thioridazine was 0.98 (95% CI 0.8 to 1.2) (n=743) compared to typical antipsychotics. Use of antiparkinsonian drugs was less common in the thioridazine group in the short term (RR 0.45, 95% CI 0.4 to 0.6)(n=1 082). Six RCTs (total n=344) randomised thioridazine against atypical antipsychotics. Global state rating did not reveal any short-term difference between thioridazine and remoxipride and sulpiride (n=203, RR not improved or worse 1.00 CI 0.8 to 1.3). Thioridazine did seem associated with cardiac adverse effects (n=74, 1 RCT, RR 'any cardiovascular adverse event' 3.17 CI 1.4 to 7.0, NNH 3 CI 2 to 5). Electrocardiogram changes were significantly more frequent in the thioridazine group (n=254, 2 RCTs, RR 2.38, CI 1.6 to 3.6, NNH 4 CI 3 to 10).

    References

    • Fenton M, Rathbone J, Reilly J, Sultana A. Thioridazine for schizophrenia. Cochrane Database Syst Rev 2007 Jul 18;(3):CD001944. [PubMed]

Primary/Secondary Keywords