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Investigation of a New Compound, B.W.203, and of Chlorpromazine in the Treatment of Psychosis

Powick Hospital, near Worcester

ABSTRACT

A blind "self" controlled comparative trial of 3 preparations, B.W.203, chlorpromazine, and a placebo, in the treatment of psychosis has been reported upon. Thirty-four in-patients received the three different treatments consecutively and in graded dosage for a period of four weeks for each treatment. The therapeutic response of each patient was measured in terms of rating-scale scores and weekly clinical or global assessments. The design of the trial was such that direct comparisons might be made between the therapeutic performance of each of the three methods of treatment and to enable some judgments to be formed as to whether any one of the six possible sequences of administration was more effective than the others, and whether the response in any one of the three main wards was significantly greater than its counterparts.

Each of the three methods of treatment was associated with some degree of positive therapeutic success in terms of both the rating scale scores and global assessments. The mean improvement scores associated with the placebo exceeded that for either chlorpromazine or B.W.203, without the differences, however, being statistically significant. The differences between the effects of the three treatments in terms of global assessments were significant at the 5 per cent. level of confidence; and the difference between the placebo and B.W.203 was significant at the 2 per cent. level. Each treatment was associated with a consistent improvement rate, in global terms; 29 per cent., 24 per cent., and 21 per cent. for placebo, chlorpromazine, and B.W.203 respectively, without the differences being statistically significant. Of the three treatments, B.W.203 was the only one associated with consistent deterioration, and the proportion, in this respect, for this preparation was 12 per cent. and significant at the 5 per cent. level of confidence.

It is deduced, therefore, that in terms of the clinical assessments made upon the 34 psychotic in-patients included in this trial, and for the respective dosages and duration of administration of the three treatments applied, the placebo was superior in therapeutic effects to compound B.W.203, and that the effects of chlorpromazine ranged somewhere between the former and the latter, without, statistically speaking, differing significantly from either. A small but significant consistent deterioration rate was identified with the administration of' B.W.203, but not with either the placebo or chlorpromazine.

From the results of the trial as a whole, it is concluded that there is a definite need for the disciplined evaluation of new, and perhaps already established drugs which may be used in the field of psychiatry.