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The British Journal of Psychiatry (1967) 113: 1425-1429. doi: 10.1192/bjp.113.505.1425
© 1967 The Royal College of Psychiatrists
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A Double-Blind Trial of Amitriptyline/Perphenazine, Perphenazine and Placebo in Chronic Withdrawn Inert Schizophrenics

A. D. COLLINS M.D., D.P.M., D.P.H.1 and J. DUNDAS M.D., M.R.C.P., D.P.M.2

1 Senior Hospital Medical Officer, High Royds Hospital, Menston, Yorkshire
2 Consultant Psychiatrist, High Royds Hospital, Menston, Yorkshire

Eighty-seven predominantly withdrawn chronic male schizophrenics were randomly assigned to one of three treatment groups. After a two-week course of placebo administration treatment was started with matching tablets containing either amitriptyline 25 mg.+perphenazine 4 mg., perphenazine 4 mg., or placebo. For the first five weeks of the trial the dose was one tablet t.i.d., and for the second five weeks, 2 tablets t.i.d. Neither the nursing staff nor the doctors concerned knew which tablets were which.

Wing Scale Form A (completed by two psychiatrists independently) and Form B (filled in by a senior nurse) yielded very similar results, rating the effectiveness of the three treatments as amitriptyline/perphenazine> perphenazine> Analysis of variance of overall improvement and of individual symptoms revealed that differences between doctors' assessments were insignificant.

Patients taking amitriptyline/perphenazine showed a significant weight gain. Regular blood examination revealed no abnormalities.

The withdrawn, inert hospitalized male schizophrenic constitutes a difficult problem to many workers in the psychiatric field. The encouraging fact emerged from this clinical trial that symptoms such as flattening and incongruity of affect, sometimes made worse by long-term administration of tranquilizing drugs, could effectively be relieved, bringing a hope that rehabilitation may perhaps be possible in some seemingly hopeless cases.

Submitted on January 3, 1967




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Copyright © 1967 The Royal College of Psychiatrists.