Comparison of acetophenazine with perphenazine in schizophrenics: Demonstration of differential effects based on computer‐derived diagnostic models

Acetophenazine was compared with a closely related phenothiazine tranquilizer, perphenazine, under controlled conditions in 98 schizophrenic men newly admitted to five Veterans Administration hospitals. Clinical response was evaluated by two separate rating scales, the Inpatient Multidimensional Psychiatric Scale (IMPS) and the Brief Psychiatric Rating Scale (BPRS). Improvement was noted in most factors of both rating devices from either treatment, with no evidence of any difference between the drugs on the basis of mean score changes. Rather marked differences were fmmd between the two drugs in relation to the spread of mean score changes, those from acetophenazine varying more than those from perphenazine. To determine whether there was any specificity of patient type which might influence reaction to drugs, further analyses were made after patients were classified as “paranoid” and “core schizophrenic” by computer analysis of initial ratings on the BPRS. Acetophenazine was found to be clearly the more efficacious drug in patients claSSified as “paranoid,” while the converse was true in the case of perphenazine. Reactions and complications of treatment were mild, not impairing the study to any extent. Perphenazine induced more extrapyramidal disturbances than acetophenazine. Abnormal laboratory findings were relatively frequent before treatment and occurred sporadically during treatment. Their significance depends entirely on accompanying clinical findings.