Capsule 23

23. Demonstration of the therapeutic efficacy of neuroleptics in schizophrenia, and the differentiation of the therapeutic effects of neuroleptics, from the effects of non-specific factors.
The superiority of several phenothiazines, including chlorpromazine, promazine, mepazine, perphenazine, prochlorpearzine, trifluoperazine, triflupromazine, flphenazine and thioridazine to an active (phenobarbital) and to an inactive placebo was conclusively demonstrated in the treatment of newly admitted and chronically hospitalized schizophrenic patients in the US Veterans Administration Collaborative Studies reported in 1960 and in the NIMH Collaborative Studues reported in 1964. In 1965, based on further analysis of data of the NIMH Collaborative Studies, Goldberg, Klerman and Cole reported that irritability, slow speech and movements,  hebephrenic symptoms, self-care and indifference to environment, responded only to active treatment, whereas auditory and non-auditory hallucinations, memory deficit, and feelings of unreality, responded also to placebo. On the basis of these findings, they suggested that the frequently held view that neuroleptics dampen only the ”accessory symptoms” of schizophrenia  without an effect on the disease process, needs to be re-evaluated.