Introduction: Cyamemazine is widely used in the treatment of schizophrenia despite a potential risk of QT interval prolongation on electrocardiogram and weak evidence for its antipsychotic efficacy. The aim of our study was to compare the level of anxiety and the co-prescription of benzodiazepines and hypnotics in schizophrenic patients who received cyamemazine (alone or in association with other antipsychotics) with those who did not receive cyamemazine.
Materials and methods: A total of 1,859 patients were enrolled according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for schizophrenia. We collected their medication prescriptions and assessment scale scores and compared patients receiving antipsychotic mono or polytherapy with or without cyamemazine at inclusion, 6-, and 12-months. As a comparison, we will use the same outcome measures in patients receiving loxapine or levomepromazine rather than cyamemazine.
Results: Brief psychiatric rating score (BPRS) scale anxiety subscores of patients under monotherapy of cyamemezine at inclusion was lower than for other antipsychotic medications but the patients received higher doses of anxiolytics. No differences in psychotropic drug use or anxiety subscores were observed between patients on antipsychotic polytherapy whether cyamemazine was used or not at inclusion, 6-, and 12-months. Patients under antipsychotic polytherapy including cyamemazine had better Global Assessment of Functioning (GAF) scores than patients under polytherapy excluding cyamemazine. Comparison of cyamemazine, loxapine, and levomepromazine groups showed no statistically significant differences in co-prescription of psychotropic drug use or anxiety subscores at inclusion, 6-, and 12-months of follow-up, respectively.
Conclusion: Our study does not find any evidence to recommend the use of cyamemazine in the anxiolytic or antipsychotic treatment in patients suffering from schizophrenia.
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