Table 114Evidence summary table: chlorpromazine versus clozapine – specific adverse events

OutcomeStudiesParticipantsEffect EstimateI2Less with
Behavior and psychosis
Agitation1531416.68 (0.37, 121.71)NEND
Depression1521649.56 (0.54, 170.62)NEND
Paranoia (increasing)1541150.30 (0.01, 6.29)NEND
BMI and weight
Weight gain (>5%)871402.21 (0.79, 6.18)NEND
Weight loss871402.21 (0.22, 22.47)NEND
Cardiovascular
Abnormal ECG154,1602590.81 (0.39, 1.68)0%ND
Cardiotoxics effects153141NENEND
Hypertension94,16023120.39 (0.17, 0.90)0%chlorpromazine
Hypotension48,87,94,109,16055431.94 (0.91, 4.13)49%ND
Orthostatic hypotension153,158,16031100.61 (0.12, 3.09)0%ND
Tachycardia87,9423080.66 (0.37, 1.20)0%ND
Cholinergic and anticholinergic
Dry mouth63,87,94,152,16155633.00 (1.67, 5.40)11%clozapine
Hypersalivation48,63,87,94,152,154,158,160,16196740.25 (0.14, 0.45)13%chlorpromazine
Ileus10911642.93 (0.12, 70.85)NEND
CNS
Dizziness94,160,16133520.62 (0.21, 1.87)50%ND
Drowsiness94,152,153,160,16154570.75 (0.58, 0.97)0%chlorpromazine
Sedation48,63,8732181.07 (0.69, 1.64)0%ND
Seizure63,87,15332322.91 (0.31, 27.28)0%ND
Slurred speech1601441.76 (0.08, 40.80)NEND
Dermatology
Dermatitis10911642.93 (0.12, 70.85)NEND
Dermatologic problem871405.50 (0.28, 107.78)NEND
Exanthema or eczema1531418.59 (0.49, 150.00)NEND
Endocrine (prolactin - thyroid)
Hyperprolactinemia6311514.94 (0.24, 101.10)NEND
EPS
Akathisia63,87,15432060.99 (0.37, 2.67)0%ND
Dystonia63,15421663.64 (0.43, 31.19)0%ND
EPS48,63,87,109,158,16064512.75 (1.48, 5.12)0%clozapine
Oculogyric crisis1541152.67 (0.13, 56.63)NEND
Parkinsonism153,1542562.67 (0.13, 56.63)NEND
Rigidity63,152,16032590.76 (0.10, 6.07)58%ND
Staggering1601440.57 (0.04, 8.53)NEND
Tardive dyskinesia (deterioration)871403.30 (0.14, 76.46)NEND
Tremor152,160,16131480.74 (0.28, 1.94)7%ND
Genito-urinary
Impotence6311512.96 (0.12, 71.55)NEND
GI
Abdominal cramps1601441.76 (0.08, 40.80)NEND
Constipation63,94,109,15246470.69 (0.44, 1.09)0%ND
Diarrhea1601440.38 (0.07, 2.04)NEND
Heartburn1601441.76 (0.08, 40.80)NEND
Nausea/vomiting87,94,16033521.06 (0.55, 2.04)0%ND
Hematology
Agranulocytosis63,942419NENEND
Blood cell count (abnormal)154115NENEND
Neutropenia10911642.93 (0.12, 70.85)NEND
Platelet count (elevated)1541150.07 (0.00, 1.03)NEND
Leukocytopenia48,63,87,9444860.71 (0.18, 2.76)55%ND
Hepato-biliary
Hepatic enzymes (elevated)87,9423080.79 (0.11, 5.71)33%ND
Jaundice871403.30 (0.14, 76.46)NEND
Sleep
Deep sleep1531410.32 (0.01, 7.38)NEND
Sleep disturbances1531416.68 (0.37, 121.71)NEND
Respiratory and airway
Cough1601440.20 (0.01, 4.53)NEND
Systemic AE
Fall (accident)871400.22 (0.01, 4.31)NEND
Fever/Chills94,16023120.35 (0.15, 0.83)0%chlorpromazine
Headache94,16023120.86 (0.43, 1.71)0%ND
Hyperthermia109,154,16032230.23 (0.05, 1.20)0%ND
Tension1601442.93 (0.15, 57.52)NEND

Significant results are in bold; AE = adverse event; BMI = body mass index; CNS = central nervous system; ECG = electrocardiogram; EPS = extrapyramidal symptoms/syndrome; GI = gastrointestinal; I2 = I–squared; ND = no difference; NE = not estimable

From: Appendix N, Summary Tables of Adverse Events

Cover of First-Generation Versus Second-Generation Antipsychotics in Adults: Comparative Effectiveness
First-Generation Versus Second-Generation Antipsychotics in Adults: Comparative Effectiveness [Internet].
Comparative Effectiveness Reviews, No. 63.
Abou-Setta AM, Mousavi SS, Spooner C, et al.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.