SynthesisThe Cochrane database of systematic reviews2010
Chlorpromazine for psychosis induced aggression or agitation.
Synthesis in The Cochrane database of systematic reviews, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 18 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 18 syntheses or guidelines pooled it, 69 citations in OpenAlex.
- "Pharmacological management of acute agitation in psychiatric patients: an umbrella review".BMC psychiatry · 2025Pooled it
- Cognitive behavioural therapy plus standard care versus standard care for persistent aggressive behaviour or agitation in people with schizophrenia.The Cochrane database of systematic reviews · 2023Pooled it
- Organisational interventions for preventing and minimising aggression directed towards healthcare workers by patients and patient advocates.The Cochrane database of systematic reviews · 2020Pooled it
- Chlorpromazine versus piperacetazine for schizophrenia.The Cochrane database of systematic reviews · 2018Pooled it
- Risperidone for psychosis-induced aggression or agitation (rapid tranquillisation).The Cochrane database of systematic reviews · 2018Pooled it
- Aripiprazole (intramuscular) for psychosis-induced aggression or agitation (rapid tranquillisation).The Cochrane database of systematic reviews · 2018Pooled it
- Rapid Tranquilization for Psychiatric Patients with Psychomotor Agitation: What is Known About it?The Psychiatric quarterly · 2017Pooled it
- Chlorpromazine versus penfluridol for schizophrenia.The Cochrane database of systematic reviews · 2017Pooled it
- Haloperidol for psychosis-induced aggression or agitation (rapid tranquillisation).The Cochrane database of systematic reviews · 2017Pooled it
- Chlorpromazine versus clotiapine for schizophrenia.The Cochrane database of systematic reviews · 2017Pooled it
- De-escalation techniques for psychosis-induced aggression or agitation.The Cochrane database of systematic reviews · 2017Pooled it
- Chlorpromazine versus metiapine for schizophrenia.The Cochrane database of systematic reviews · 2017Pooled it
- Droperidol for psychosis-induced aggression or agitation.The Cochrane database of systematic reviews · 2016Pooled it
- Haloperidol for long-term aggression in psychosis.The Cochrane database of systematic reviews · 2016Pooled it
- Haloperidol plus promethazine for psychosis-induced aggression.The Cochrane database of systematic reviews · 2016Pooled it
- Chlorpromazine versus atypical antipsychotic drugs for schizophrenia.The Cochrane database of systematic reviews · 2016Pooled it
- Zuclopenthixol acetate for acute schizophrenia and similar serious mental illnesses.The Cochrane database of systematic reviews · 2012Pooled it
- Brazilian guidelines for the management of psychomotor agitation. Part 2. Pharmacological approach.Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)Pooled it
- A Comprehensive Understanding of Psychomotor Agitation: From Causes to Hospital Care.Current neuropharmacology · 2025Review
- Prescription Patterns of Intramuscular Medication for Psychomotor Agitation: A Survey of Italian Psychiatrists.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAgitated or violent behaviour constitutes 10% of all emergency psychiatric treatment. Some guidelines do not recommend the use of chlorpromazine for rapid tranquillisation but it is still often used for this purpose.
objectivesTo examine the effects of oral or intramuscular chlorpromazine for psychosis induced agitation or aggression. SEARCH STRATEGY: We searched the Cochrane Schizophrenia Group Trials Register (up to July 2009) which is based on regular searches of CINAHL, EMBASE, MEDLINE and PsycINFO. SELECTION CRITERIA: Randomised control trials or double blind trials (implying randomisation) comparing chlorpromazine with another drug or placebo for people who are thought to be acutely aggressive or agitated due to psychotic illness. DATA COLLECTION AND ANALYSIS: We extracted data independently. For dichotomous data we calculated relative risks (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis based on a fixed-effects model. MAIN
resultsOne study (total n=30) met the inclusion criteria. When compared with haloperidol (Man 1973) (1 RCT, n=30) people allocated chlorpromazine were no more likely to have one additional injection than those allocated haloperidol (RR 3.00 CI 0.13 to 68.26). This remained true for 2-4 injections (RR 0.90 CI 0.52 to 1.55) and for 5 or more injections (RR 0.75 CI 0.20 to 2.79). Two people allocated chlorpromazine had sudden, serious hypotension while no one allocated haloperidol had such an effect (RR 5.00 CI 0.26 to 96.13). No extrapyramidal symptoms were observed. One person allocated chlorpromazine developed status epilepticus (RR 3.00 CI 0.13 to 68.26). AUTHORS'
conclusionsOverall the quality of evidence is limited, poor and dated. Where drugs that have been better evaluated are available, it may be best to avoid use of chlorpromazine. Where chlorpromazine is used for acute aggression or where choices are limited, relevant trials are possible and urgently needed.
Indexed as
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.