The Treatment of Restless Psychotics with Methotrimeprazine (Veractil)

Abstract

Since the introduction of methotrimeprazine (Veractil) to psychiatry in 1956 by the French workers, Sigwald, Henne, Bouttier, Raymoneaud and Quetin (1), this drug has been used here and on the Continent for the treatment of various psychiatric conditions with varying and inconsistent success. A rapid review of some examples in the literature will suffice to illustrate this. Deschamps and Madre (2) stated that the drug was more rapidly effective and more powerful than chlorpromazine (Largactil). Gayral et al. (3) reported on their findings in 409 patients, most of them (304) out-patients, and the majority (316) with depression: it was considered that Veractil was not an adequate substitute for electroplexy (E.C.T.) in depression. Larue and Gosselin (4) treated 82 patients with a variety of disorders including 2 cases of trigeminal neuralgia, with marked success. Letailleur, le Borgne and Lebrun (5) reported the side-effects of drowsiness and fainting to be relatively common, but with no true Parkinsonism, in a series of 75 patients of which they regarded 36 as cured and 25 as improved. Baruk, Launay and Roberti (6) claimed good results, not only in depression, as stated by others, but also in obsessive and digestive neuroses; and in patients with syndromes in which other neuroleptics were usually without effect. Deschales, Lanteri-Lausa and Fargeon (7) however concluded that Veractil was no more efficacious than other neuroleptics though they preferred it for depressives: it could usefully be combined with E.C.T. in these cases but it could not replace it. Baker and Thorpe (8) found no difference in comparison with Largactil while treating deteriorated schizophrenics, except that the effective dose of Veractil was only two-thirds that of Largactil. Leitch and Seager (9) found no statistical significance in a placebo-controlled study comparing Veractil, Largactil, acepromazine and promazine. But Quinn, Johnston, Latner and Kiloh (10) again reported a 42 per cent. clinical improvement in patients given Veractil compared with Largactil and a placebo in 146 schizophrenics using the working capacity in males and the degree of deterioration in females as pointers for assessment.