A double-blind trial to investigate the effects of Thorazine (Largactil, chlorpromazine), Compazine (Stemetil, prochlorperazine) and Stelazine (trifluoperazine) in paranoid schizophrenia.

IN the early phenothiazine literature the ataractic properties of Thorazine in the control of disturbed, hyperactive schizophrenics were described (Kurland, 1955; Hall and Dunlap, 1955; Lehmann, 1955). Kurland (1955) gives an excellent description of the powerful activity ofThorazineinthis sphere, namely the control of hyperkinesis and hostile, aggressive behaviour; however, he found that there was little basic change in delusional thought disorder other than to divorce the abnormal thinking from its affective attachment. It was noted that the clinical improvement was most dramatic when the affective component of the illness was most marked. Hall and Dunlap (1955) felt that there was significant reduc tion in delusional ideation but noted that the schizophrenic process was not affected by Thorazine medication. With Compazine (Stemetil) stress was laid on different spheres of thera peutic activity, namely in the control of abnormal thought content and in influencing psychomotor activity. Compazine was reported as having active therapeutic properties in the amelioration of delusional ideation and hallucina tions (Mime and Berliner, 1958; Denham, 1958; Winkelman, 1959). It would appear that Compazine has the dual ability to inhibit hyper-motility and to stimulate activity in the underactive patient. Freyhan (1958) found that it had a highly selective action in hyperkinetic syndromes, but other authors (Mime and Berliner, 1958 and Frierson, 1958) found it equally effective in counteracting * dull, withdrawn, apathetic, asocial and negativistic behaviour. In a comparative study of chlorpromazine (Thorazine-Largactil) and prochlorperazine (Com pazine-Stemetil), Dransfield (1958) found these drugs equally effective in con trolling hostile, aggressive, hyperactive behaviour; however, he found chlor promazine superior to prochiorperazine in counteracting apathy. It would appear that few toxic side-effects, for example bone marrow and liver toxicity (Wilcox, 1955), have been recorded with Compazine and it also had the advantage of producing less somnolence than Thorazine. The predominant side-effects were