Encephale. 2025 Mar 15:S0013-7006(25)00036-3. doi: 10.1016/j.encep.2025.01.003. Online ahead of print.

ABSTRACT

BACKGROUND: Cyamemazine, a phenothiazine antipsychotic with anxiolytic and sedative properties, is commonly used in the management of severe mental disorders (SMDs) such as schizophrenia, bipolar disorder, and major depressive disorder. Despite its unique pharmacological profile, the impact of cyamemazine on clinical outcomes, treatment adherence, and quality of life (QoL) remains inadequately studied. This study addresses the significant gap in understanding the clinical impact of cyamemazine, a widely used yet under-researched antipsychotic.

METHODS: This observational study was conducted at a university psychiatry unit in Marseille, France, involving patients with SMDs. Sociodemographic, clinical, and comorbid characteristics were assessed, along with treatment adherence, QoL, and side effects using validated instruments including the Medication Adherence Rating Scale (MARS) and the Schizophrenia Quality of Life Scale (SQoL-18). Multivariate analyses were performed to explore the associations between cyamemazine use and clinical outcomes.

RESULTS: A total of 1,248 patients were included with 55 (4.4%) using cyamemazine. Cyamemazine users presented more severe clinical profiles, with higher anxiety, more hospitalizations, and poorer functioning. Although cyamemazine’s anxiolytic effects may improve adherence, its sedative and metabolic side effects were associated with reduced QoL and functional impairment.

CONCLUSIONS: The study highlights the need for personalized treatment strategies that weigh the benefits of cyamemazine against its potential risks. Integrating pharmacological and non-pharmacological interventions could enhance patient outcomes.

PMID:40090830 | DOI:10.1016/j.encep.2025.01.003