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Pimozide for schizophrenia or related psychoses

  1. Meghana Mothi1,*,
  2. Stephanie Sampson2

Editorial Group: Cochrane Schizophrenia Group

Published Online: 5 NOV 2013

Assessed as up-to-date: 17 MAY 2007

DOI: 10.1002/14651858.CD001949.pub3


How to Cite

Mothi M, Sampson S. Pimozide for schizophrenia or related psychoses. Cochrane Database of Systematic Reviews 2013, Issue 11. Art. No.: CD001949. DOI: 10.1002/14651858.CD001949.pub3.

Author Information

  1. 1

    Newsam Centre, Seacroft Hospital, General Adult Psychiatry, Leeds, UK

  2. 2

    The University of Nottingham, Cochrane Schizophrenia Group, Nottingham, UK

*Meghana Mothi, General Adult Psychiatry, Newsam Centre, Seacroft Hospital, Leeds and York NHS Foundation Trust, York Road, Leeds, LS14 6WB, UK. m.mothi@nhs.net.

Publication History

  1. Publication Status: New search for studies and content updated (conclusions changed)
  2. Published Online: 5 NOV 2013

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[Figure 1]
Figure 1. Pimozide structure.
[Figure 2]
Figure 2. Funnel plot of comparison: 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, outcome: 3.3 Global state: 2. No improvement.
[Figure 3]
Figure 3. Study flow diagram: combined from the 2002 initial review search; the 2005 first update search; and the current 2013 update search.
[Figure 4]
Figure 4. Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
[Figure 5]
Figure 5. Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
[Figure 6]
Figure 6. Forest plot of comparison: 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, outcome: 3.10 Adverse effects: 1. Extrapyramidal adverse effects - specific.
[Analysis 1.1]
Analysis 1.1. Comparison 1 PIMOZIDE versus PLACEBO, Outcome 1 Global state: 1. Relapse - clinical diagnoses.
[Analysis 1.2]
Analysis 1.2. Comparison 1 PIMOZIDE versus PLACEBO, Outcome 2 Global state: 2. No improvement.
[Analysis 1.3]
Analysis 1.3. Comparison 1 PIMOZIDE versus PLACEBO, Outcome 3 Mental state: 1. Specific symptoms.
[Analysis 1.4]
Analysis 1.4. Comparison 1 PIMOZIDE versus PLACEBO, Outcome 4 Adverse effects: 1. Extrapyramidal adverse effects.
[Analysis 1.5]
Analysis 1.5. Comparison 1 PIMOZIDE versus PLACEBO, Outcome 5 Adverse effects: 2. Anticholinergic effects.
[Analysis 1.6]
Analysis 1.6. Comparison 1 PIMOZIDE versus PLACEBO, Outcome 6 Adverse effects: 3. Cardiovascular effects.
[Analysis 1.7]
Analysis 1.7. Comparison 1 PIMOZIDE versus PLACEBO, Outcome 7 Adverse effects: 4. Abnormal laboratory tests.
[Analysis 1.8]
Analysis 1.8. Comparison 1 PIMOZIDE versus PLACEBO, Outcome 8 Adverse effects: 5. Central nervous system effects.
[Analysis 1.9]
Analysis 1.9. Comparison 1 PIMOZIDE versus PLACEBO, Outcome 9 Adverse effects: 6. Dermatological effects.
[Analysis 1.10]
Analysis 1.10. Comparison 1 PIMOZIDE versus PLACEBO, Outcome 10 Adverse effects: 7. Endocrine effects.
[Analysis 1.11]
Analysis 1.11. Comparison 1 PIMOZIDE versus PLACEBO, Outcome 11 Adverse effects: 8. Gastrointestinal effects.
[Analysis 1.12]
Analysis 1.12. Comparison 1 PIMOZIDE versus PLACEBO, Outcome 12 Adverse effects: 9. Other.
[Analysis 1.13]
Analysis 1.13. Comparison 1 PIMOZIDE versus PLACEBO, Outcome 13 Leaving the study early: 1. Due to adverse effects.
[Analysis 1.14]
Analysis 1.14. Comparison 1 PIMOZIDE versus PLACEBO, Outcome 14 Leaving the study early: 2. Any reason.
[Analysis 2.1]
Analysis 2.1. Comparison 2 PIMOZIDE versus PLACEBO: withdrawal study, Outcome 1 Global state: 1. Relapse - clinical diagnoses.
[Analysis 2.2]
Analysis 2.2. Comparison 2 PIMOZIDE versus PLACEBO: withdrawal study, Outcome 2 Mental state: 1. Use of additional medication.
[Analysis 2.3]
Analysis 2.3. Comparison 2 PIMOZIDE versus PLACEBO: withdrawal study, Outcome 3 Adverse effects: 1. Death.
[Analysis 2.4]
Analysis 2.4. Comparison 2 PIMOZIDE versus PLACEBO: withdrawal study, Outcome 4 Leaving the study early: 1. Any reason.
[Analysis 3.1]
Analysis 3.1. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 1 Service utilisation: 1. Hospital admission.
[Analysis 3.2]
Analysis 3.2. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 2 Global state: 1. Relapse - clinical diagnoses.
[Analysis 3.3]
Analysis 3.3. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 3 Global state: 2. No improvement.
[Analysis 3.4]
Analysis 3.4. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 4 Global state: 3. Average score - CGI (high = poor).
[Analysis 3.5]
Analysis 3.5. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 5 Mental state: 1. Average score - BPRS (high = poor).
[Analysis 3.6]
Analysis 3.6. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 6 Mental state: 2. Average score - MADRS (high = poor, skewed).
[Analysis 3.7]
Analysis 3.7. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 7 Mental state: 3. No improvement.
[Analysis 3.8]
Analysis 3.8. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 8 Mental state: 4. Specific symptoms.
[Analysis 3.9]
Analysis 3.9. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 9 Mental state: 5. Use of additional medication.
[Analysis 3.10]
Analysis 3.10. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 10 Adverse effects: 1. Extrapyramidal adverse effects - specific.
[Analysis 3.11]
Analysis 3.11. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 11 Adverse effects: 2. Extrapyramidal adverse effects: average score - EPS (high = poor, skewed).
[Analysis 3.12]
Analysis 3.12. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 12 Adverse effects: 3. Death.
[Analysis 3.13]
Analysis 3.13. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 13 Adverse effects: 4. Anticholinergic effects.
[Analysis 3.14]
Analysis 3.14. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 14 Adverse effects: 5. Cardio-vascular effects.
[Analysis 3.15]
Analysis 3.15. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 15 Adverse effects: 6. Abnormal laboratory tests.
[Analysis 3.16]
Analysis 3.16. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 16 Adverse effects: 7. Central nervous system effects.
[Analysis 3.17]
Analysis 3.17. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 17 Adverse effects: 8. Dermatological effects.
[Analysis 3.18]
Analysis 3.18. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 18 Adverse effects: 9. Endocrine effects.
[Analysis 3.19]
Analysis 3.19. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 19 Adverse effects: 10. Gastrointestinal effects.
[Analysis 3.20]
Analysis 3.20. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 20 Adverse effects: 11. Genitourinary effects.
[Analysis 3.21]
Analysis 3.21. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 21 Adverse effects: 12. Other.
[Analysis 3.22]
Analysis 3.22. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 22 Social functioning: 1. Average score - SBAS (high = poor, skewed).
[Analysis 3.23]
Analysis 3.23. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 23 Leaving the study early: 1. Due to relapse.
[Analysis 3.24]
Analysis 3.24. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 24 Leaving the study early: 2. Due to adverse effects.
[Analysis 3.25]
Analysis 3.25. Comparison 3 PIMOZIDE versus ANY ANTIPSYCHOTIC, Outcome 25 Leaving the study early: 3. Any reason.
[Analysis 4.1]
Analysis 4.1. Comparison 4 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC, Outcome 1 Global state: 1. Relapse - clinical diagnoses.
[Analysis 4.2]
Analysis 4.2. Comparison 4 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC, Outcome 2 Leaving the study early: 1. Any reason.
[Analysis 5.1]
Analysis 5.1. Comparison 5 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + PLACEBO, Outcome 1 Global state: 1. Average score - CGI (high = poor, skewed).
[Analysis 5.2]
Analysis 5.2. Comparison 5 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + PLACEBO, Outcome 2 Global state: 2. Average score - CGI-S (high = poor).
[Analysis 5.3]
Analysis 5.3. Comparison 5 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + PLACEBO, Outcome 3 Global state: 3. Average score - CGI-I (high = poor).
[Analysis 5.4]
Analysis 5.4. Comparison 5 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + PLACEBO, Outcome 4 Mental state: 1. Average score - BPRS (high = poor).
[Analysis 5.5]
Analysis 5.5. Comparison 5 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + PLACEBO, Outcome 5 Mental state: 2. Average score - BPRS psychosis subscale (high = poor).
[Analysis 5.6]
Analysis 5.6. Comparison 5 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + PLACEBO, Outcome 6 Mental state: 3. Average score - PANSS (high = poor, skewed).
[Analysis 5.7]
Analysis 5.7. Comparison 5 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + PLACEBO, Outcome 7 Mental state: 4. Average score - SANS (high = poor).
[Analysis 5.8]
Analysis 5.8. Comparison 5 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + PLACEBO, Outcome 8 Adverse effects: 1. Extrapyramidal adverse effects - specific.
[Analysis 5.9]
Analysis 5.9. Comparison 5 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + PLACEBO, Outcome 9 Adverse effects: 2. Extrapyramidal adverse effects: average score - ESRS (high = poor, skewed).
[Analysis 5.10]
Analysis 5.10. Comparison 5 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + PLACEBO, Outcome 10 Adverse effects: 3. Cardiovascular effects.
[Analysis 5.11]
Analysis 5.11. Comparison 5 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + PLACEBO, Outcome 11 Adverse effects: 4. Cardiovascular effects - average score (high = poor).
[Analysis 5.12]
Analysis 5.12. Comparison 5 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + PLACEBO, Outcome 12 Adverse effects: 5. Cardiovascular effects - average score (high = poor, skewed).
[Analysis 5.13]
Analysis 5.13. Comparison 5 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + PLACEBO, Outcome 13 Adverse effects: 6. Abnormal laboratory tests - average score (skewed).
[Analysis 5.14]
Analysis 5.14. Comparison 5 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + PLACEBO, Outcome 14 Adverse effects: 7. Other.
[Analysis 5.15]
Analysis 5.15. Comparison 5 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + PLACEBO, Outcome 15 Quality of life: 1. Average score - SLOF (high = better, skewed).
[Analysis 5.16]
Analysis 5.16. Comparison 5 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + PLACEBO, Outcome 16 Leaving the study early: 1. Due to adverse effects.
[Analysis 5.17]
Analysis 5.17. Comparison 5 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + PLACEBO, Outcome 17 Leaving the study early: 2. Any reason.
[Analysis 6.1]
Analysis 6.1. Comparison 6 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + ANY ANTIPSYCHOTIC, Outcome 1 Global state: 1. No improvement.
[Analysis 6.2]
Analysis 6.2. Comparison 6 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + ANY ANTIPSYCHOTIC, Outcome 2 Global state: 2. Average score - CGI-S (high = poor).
[Analysis 6.3]
Analysis 6.3. Comparison 6 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + ANY ANTIPSYCHOTIC, Outcome 3 Global state: 3. Average score - CGI-I (high = poor).
[Analysis 6.4]
Analysis 6.4. Comparison 6 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + ANY ANTIPSYCHOTIC, Outcome 4 Mental state: 1. Average score - SANS (high = poor).
[Analysis 6.5]
Analysis 6.5. Comparison 6 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + ANY ANTIPSYCHOTIC, Outcome 5 Mental state: 2. Average score - SAPS (high = poor, skew).
[Analysis 6.6]
Analysis 6.6. Comparison 6 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + ANY ANTIPSYCHOTIC, Outcome 6 Adverse effects: 1. Extrapyramidal adverse effects - average score (high = poor, skew).
[Analysis 6.7]
Analysis 6.7. Comparison 6 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + ANY ANTIPSYCHOTIC, Outcome 7 Adverse effects: 2. Anticholinergenic effects - average score (high = poor, skew).
[Analysis 6.8]
Analysis 6.8. Comparison 6 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + ANY ANTIPSYCHOTIC, Outcome 8 Adverse effects: 3. Cardio-vascular effects - average score (high = poor, skew).
[Analysis 6.9]
Analysis 6.9. Comparison 6 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + ANY ANTIPSYCHOTIC, Outcome 9 Adverse effects: 4. Autonomic effects - average score (high = poor, skew).
[Analysis 6.10]
Analysis 6.10. Comparison 6 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + ANY ANTIPSYCHOTIC, Outcome 10 Adverse effects: 5. Central nervous system effects - average score (high = poor, skew).
[Analysis 6.11]
Analysis 6.11. Comparison 6 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + ANY ANTIPSYCHOTIC, Outcome 11 Adverse effects: 6. Endocrine effects - average score (high = poor, skew).
[Analysis 6.12]
Analysis 6.12. Comparison 6 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + ANY ANTIPSYCHOTIC, Outcome 12 Adverse effects: 7. Gastrointestinal effects - average score (high = poor, skew).
[Analysis 6.13]
Analysis 6.13. Comparison 6 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + ANY ANTIPSYCHOTIC, Outcome 13 Adverse effects: 8. Gastrointestinal effects.
[Analysis 6.14]
Analysis 6.14. Comparison 6 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + ANY ANTIPSYCHOTIC, Outcome 14 Adverse effects: 9. Other.
[Analysis 6.15]
Analysis 6.15. Comparison 6 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + ANY ANTIPSYCHOTIC, Outcome 15 Adverse effects: 10. Other - average score (high = poor, skew).
[Analysis 6.16]
Analysis 6.16. Comparison 6 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + ANY ANTIPSYCHOTIC, Outcome 16 Leaving the study early: 1. Due to adverse effects.
[Analysis 6.17]
Analysis 6.17. Comparison 6 PIMOZIDE + ANY ANTIPSYCHOTIC versus ANY ANTIPSYCHOTIC + ANY ANTIPSYCHOTIC, Outcome 17 Leaving the study early: 2. Any reason.
[Analysis 7.1]
Analysis 7.1. Comparison 7 Sensitivity Analysis: PIMOZIDE vs ANY ANTIPSYCHOTIC - 1. risk of bias, Outcome 1 Mental state: 1. No improvement.
[Analysis 7.2]
Analysis 7.2. Comparison 7 Sensitivity Analysis: PIMOZIDE vs ANY ANTIPSYCHOTIC - 1. risk of bias, Outcome 2 Extrapyramidal adverse effects: 1. Specific - Parkinsonism.