***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In a double-blind comparative trial of sulpiride ( 600 - 1,800 mg/day ) and trifluoperazine ( 15 - 45 mg/day ) in 38 chronic schizophrenic patients , ratings of therapeutic results and unwanted effects were made at two-weekly interviews during the six weeks treatment period . The results show that sulpiride has neuroleptic properties and a spectrum of therapeutic activity similar to that of trifluoperazine . There was an association between plasma sulpiride levels and therapeutic response after four weeks ' treatment Taking even this restricted group of patients , the aim of establishing clear cut differences between the drugs has not been achieved . The most clear cut finding was that no statistically significant difference was found between the ability of the two drugs , chlorpromazine and trifluoperazine , to improve motor activity in underactive schizophrenic patients . There were however , a number of observations which may be of interest . For the more active patients an overall measure of performance at the factory task showed an inconstant and non-significant initial improvement with both active drugs with maximum effect at the end of six weeks . There-after performance deteriorated , and when active drugs were reintroduced this deterioration was not reversed . The less active behaved differently . At the factory task they improved progressively through-out the experiment , but the greatest increment in their performance occurred during the Pl phase . No group 's speed of work was changed differentially by the two drugs . The least active group A increased their speed of work more during the six weeks Pl phase than at any other time ; Group B showed similar improvement during the P1 phase , but did not improve further when drugs were reintroduced ; Group C showed virtually no change in speed of work during the three phases of the experiment . When on drugs there was a small but highly statistically significant improvement over pre-drug scores on the Venables scale , indicating that the two drugs were effective . No significant difference between drugs was found , and after the first six weeks of treatment the maximum response was reached , with some worsening thereafter . There is a strong suggestion that the worsening in behaviour during the intervening placebo phase seen on the Venables scale occurs only in those previously treated with chlorpromazine . To this extent , therefore , trifluoperazine is to be preferred as a treatment . On this scale , as with the factory task , gains in behaviour obtained during the first six weeks of treatment were not repeated during the latter part of the cross-over . Strenuous attempts were made to maintain the environment constant for all groups , so that it is unlikely that chance environmental stimulation could be the sole explanation for these changes . A more likely explanation seems to be that , for the very inactive , once new patterns of behaviour have been initiated with the aid of drugs further improvement may occur without continuous medication . For the more active , however , starting drugs may also produce a temporary improvement , but the improvement is inconstant , it does not last as long and may be lost even when drugs are continued . Intermittent medication is evidently effective for inactive patients and may be advantageous . The more active seem to be improved to a much smaller extent by these drugs . The correlation , steadily increasing with treatment , between the two factors of the Venables scale suggests that both drugs have a beneficial effect on another puzzling aspect of the chronic schizophrenic : the differences between tests within individuals which they show on most measures of behaviour . This is an area of performance of importance therapeutically , but one which hitherto has been neglected in drug studies . We found no evidence to suggest that intermittent medication would have an adverse effect on this aspect of behaviour A comparison between regular and high doses of Trifluoperazine ( TR-60 mg and TR-600 mg ) was made on 26 newly admitted schizophrenics with acute psychotic symptoms . Eleven received the regular dose of the drug ( TR-60 mg ) and 15 received the high dose ( TR-600 mg ) . Treatment 's duration was 6 weeks . Psychiatric evaluations were done by means of Patient Personal Data Inventory , Brief Psychiatric Rating Scale , Impatient Multidimensional Psychiatric Scale , Digit Symbol Test , Continuous Scanning , Side Effects , and Extrapyramidal Status . Almost all patients from both groups generally improved from the beginning to the end of the study with TR- , but the results provide no support for the contention that very high doses of TR-are more effective than regular doses Seventy patients on acute intensive treatment with chlorpromazine , trifluoperazine , and fluphenazine were placed at r and om in two groups . Group A treated with benztropine methanesulfonate had 40 extrapyramidal symptoms of which 35 improved . Blurred vision or dry mouth developed in 17 instances . Group B treated with procyclidine had 40 extrapyramidal symptoms of which 39 improved with the development of only one side effect — blurred vision — in two patients . On the basis of this study it appears that procyclidine was the most effective drug in alleviating extrapyramidal symptoms . The number of side effects developing with procyclidine were at a minimum The relative efficacy of 4 tranquilizers was investigated in 66 chronic schizophrenics who had been hospitalized for 10.01 years ( mean ) . The role of adding an anti-depressant was also studied . Following a 4 week placebo period , high dosage tranquilizers were given for 16 weeks and amitriptyline was added for the following 16 weeks . Statistical analyses of the various change measures revealed that patients worsened significantly on placebo , all 4 tranquilizers were significantly better than placebo for symptom reduction and maximum improvement was attained within 16 weeks of tranquilizer administration . No significant differences in efficacy were observed among the 4 tranquilizers and addition of amitriptyline did not confer any additional therapeutic advantage In a population of hostile suspicious patients mostly fitting into the paranoid schizophrenic category , haloperidol and trifluoperazine when compared in double-blind fashion were equal in global clinical ratings . Haloperidol showed significantly more improvement on the Brief Psychiatric Rating Scale and on the Global Paranoia rating . On the Global Hostility rating and in speed of onset of activity , the effects of the two drugs were not significantly different . In a small sub- sample of extremely uncooperative patients  haloperidol showed marked effects , but trifluoperazine showed only minimal or moderate effects Because the importance of tranquilizing drugs has been difficult to assess precisely , the author undertook a study on the effect of the withdrawal of chlorpromazine and trifluoperazine on hospitalized male schizophrenics in Engl and . Although there were no major relapses among the placebo group , changes occurred that were sometimes disabling The two major tranquillizers , methylperidol and trifluoperazine , are compared as treatments for underactive , chronic schizophrenic patients . They are found to be equally effective SINCE THE discovery of rapid eye movements ( REMs ) associated with a desynchronized electroencephalogram ( EEG ) during behavioral sleep 1 and the correlation of this sleep stage with dreaming , 2 considerable investigation of REM sleep has been instituted to assess its significance in normal man and in various psychiatric illnesses . The similarity between mentation during dreaming in normal people and thought patterns in schizophrenia has led to many investigations of REM sleep in this disease . These studies have not consistently demonstrated marked differences in REM sleep between schizophrenics and normal subjects . 3 Similarly , REM sleep does not appear to be markedly altered in mental illness characterized primarily by depression . 3 Several recent studies have suggested , however , that Stage 4 or delta sleep may be decreased in schizophrenia 4 and depressive psychosis . 5,6 Various drugs used in the treatment of mental illness have Thirty chronic schizophrenic patients participated in a double-blind crossover trial of thiothixene ( Navane ) and a control drug combination of trifluoperazine and chlorpromazine . No statistically significant difference was found between the two drug conditions on numerous behavioural scales . Experience with thiothixene suggested that it was comparable with control drugs in the activation of withdrawn patients but needs to be used in combination with a more sedative antipsychotic agent in the treatment of some paranoid patients • Prolixin ( Fluphenazine ) Enanthate , an injectible esterified trifluoromethyl phenothiazine derivative with an extended duration of action , was design ed for use with schizophrenic patients who are unreliable in taking oral medications . The magnitude of the problem is indicated by the estimate that 46 % of out- patients ~O,~1 and 20 % of in- patients ll have difficulties in this area . A number of studies ' · ' ; ' ; " " , 15,1 ; , , ' have reported the usefulness of Prolixin Enanthate in the treatment of schizophrenics in both inpatient and outpatient setting s , although some1,~. " indicated difficulty with side effects . All of these studies , however , were clinical rather than experimental evaluations . Only one ' used a control group and this was comprised of patients known to be or suspected of not taking oral medication . None of A small study was carried out to compare the clinical effects of the two butyrophenone compounds , triperidol and haloanisone to those of trifluoperazine , in a population of chronically hospitalized long-term schizophrenics in a closed ward setting . Twenty-seven patients were r and omly assigned to one of the three compounds , and treated for a twelve-week period under double-blind conditions . Observations with a modified PRP rating scale , based on ward nurses ' monthly ratings , revealed an over-all improvement after one month of treatment , but differences between the three drugs were not apparent and the over-all decrease of this PRP morbidity score was not sustained in subsequent ratings . Psychiatrist 's ratings on the IMPS revealed several symptom-factor differences with treatment . Between-drug differences on these factors were apparent . They are discussed in terms of the possible differences in type of drug action which they may reflect . The incidence of parkinsonistic side effects with each drug is presented . In no case did the side effects prevent continued treatment with the compound The st and ard drug Stelazine ( STEL ) , at a dose of 50 mg/day , exhibited therapeutic activity significantly different from placebo ( PL ) activity on several variables , most notably BPRS , attesting to the sensitivity of the experiment . On the other h and , the investigational drug , loxapine ( LOX ) , in doses of 100 mg/day for four weeks , could be differentiated from PL as treatment in the described population on only one variable ( NGI-Imp . ) and one item of the BPRS . On several variables , positive trends were noted , but the differences from PL did not attain the critical values necessary for statistical significance at P smaller than 0.05 . One might speculate that the relatively short duration of treatment in this study might account for the difference between these disappointing results and the more gratifying results of a previous loxapine study in chronic long-term institutionalized schizophrenics with the same oral dose range for the majority was 40 - 55 . One patient was below the age of 40 , and two were above the 55 level . The diagnosis for all patients was schizophrenia . The SUbtype was not considered to be important , especially at this stage in their psychosis . Length of illness with one exception ( 13 years ) was in the 20 - 25 year range . Three patients were not receiving medication at the time the project was instituted , but even these three had received phenothiazine medication at intervals . The remainder were receiving phenothiazines . Twenty-two of the group were being treated with trifluoperazine . Two groups matched by pairs for age , length of illness , clinical SUbtype and general behaviour were made by a staff member not involved in the assessment s during the study . The assignment of these groups to high and usual dosage was made by the pharmacist who set up the individual medication according to the schedule described below . Each patient received two capsules identical in appearance each day . For a two week period prior to the initiation of the program all medication for the patients involved was discontinued . Upon a patient 's entry into the study an evaluation was made of his current clinical status , using Lorr 's ( 1 ) Multidimensional Rating Scale for rating psychiatric patients . For the following week placebo capsules were given twice daily to each patient , at which time a second evaluation was made . From this point on the double-blind technique was followed . The ' usual dosage ' group remained on a dosage of 10 mgms . daily throughout , whereas the ' high dosage ' group had their dosage increased by increments of 20 mgms . daily every two weeks until Twenty adult female schizophrenics were included in a double-blind , between-patient trial . Patients received either 20 mg . trifluoperazine or 150 mg . oxypertine daily in capsule form . The dose could be altered to 10 or 30 mg . trifluoperazine ( or 120 to 180 mg . oxypertine ) at the doctor 's discretion , still maintaining the double-blind discipline . The trial drugs were administered for six weeks , after a three-week period of placebo treatment . Ratings were made throughout the trial period and for four subsequent weeks , using the Wing ` A ' and Venables rating scales . Laboratory tests , including S.G.O.T. , S.P.G.T. , alkaline phosphatase , P.C.V. , E.S.R. haemoglobin , and total and differential white cell counts , were also carried out . The results of this trial do not suggest that oxypertine is superior to trifluoperazine in activating withdrawn schizophrenics . Significantly lower values for white cell count and haemoglobin were found in the  oxypertine group . Side-effects , which comprised mainly vomiting , diarrhoea , dizziness and tremor , and were not clinical ly significant , were observed more frequently after administration of trifluoperazine than after oxypertine THE FACT that neuroleptic drugs can cause dyskinesias other than parkinsonism or acute dystonia has been well documented by more than 50 papers . I review ed the literature on this subject in 1968 1 ; Schmidt and Jarcho , among others , described the most important manifestations of these abnormalities in an issue of the Archives in 196 
    Output:
    
REVIEW ER 'S CONCLUSIONS Although there are shortcomings and gaps in the data , there appears to be enough consistency over different outcomes and periods to confirm that trifluoperazine is an antipsychotic of similar efficacy to other commonly used neuroleptics for people with schizophrenia .
Its adverse events profile is similar to that of other drugs .
It has been cl aim ed that trifluoperazine is effective at low doses for patients with schizophrenia but this does not appear to be based on good quality trial based evidence