Double‐blind comparative clinical trial of pimozide and chlorpromazine in mania

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Abstract
Pimozide (PMZ), a relatively specific dopamine (DA)-receptor-blocking drug, was compared to chlorpormazine (CPZ) in a double-blind, between-patient clinical trial in mania. The trial lasted 14 days. Patients (23) who fulfilled Feighner''s criteria for mania entered the trial (1 patient entering on 2 separate occasions). Both drugs led to clinical improvement, with a significant effect seen within 24 h. According to 1 of the 2 rating scales used, initial improvement was greater with chlorpromazine, probably due to its greater sedative effect. By 7 days both drugs were equally effective. Sedative side effects were more frequent in patients on CPZ; extrapyramidal side effects were more frequent with PMZ. Since the relatively specific DA-receptor-blocking drug PMZ was as effective as CPZ in the treatment of mania, hyperactivity of central DA pathways may be involved in the pathogenesis of this condition.