BACKGROUND: Antipsychotic therapy is the mainstay of treatment for people with 
schizophrenia. In recent years new or atypical antipsychotics have been 
introduced. These are less likely to produce movement disorders and raise serum 
prolactin. Researchers have suggested that molindone should be classified as an 
atypical antipsychotic.
OBJECTIVES: To determine the effects of molindone compared with placebo, typical 
and other atypical antipsychotic drugs for schizophrenia and related psychoses.
SEARCH STRATEGY: For the original search we searched the following databases: 
Biological Abstracts (1980-1999), The Cochrane Library CENTRAL (Issue 1, 1999), 
The Cochrane Schizophrenia Group's Register (January 1999), CINAHL (1982-1999), 
EMBASE (1980-1999), MEDLINE (1966-1999), LILACS (1982-1999), PSYNDEX 
(1977-1999), and PsycLIT (1974-1999). We also searched pharmaceutical databases 
on the Dialog Corporation Datastar and Dialog and the references of all 
identified studies for further trials. Finally, we contacted the manufacturer of 
molindone and the authors of any relevant trials. For the update of this review, 
we searched The Cochrane Schizophrenia Group's Trials Register (August 2005).
SELECTION CRITERIA: We included all randomised controlled trials that compared 
molindone to other treatments for schizophrenia and schizophrenia-like 
psychoses.
DATA COLLECTION AND ANALYSIS: We extracted data independently and analysed on an 
intention to treat basis calculating, for binary data, the fixed effect relative 
risk (RR), their 95% confidence intervals (CI), and the number needed to treat 
or harm (NNT or NNH). We excluded data if loss to follow up was greater than 
50%.
MAIN RESULTS: We included fourteen studies. Duration ranged from very short (10 
days) studies of the intramuscular preparation, to trials lasting over three 
months. For measures of global assessment, available data do not justify any 
conclusions on the comparative efficacy of molindone and placebo. When compared 
to other typical antipsychotics we found no evidence of a difference in 
effectiveness (doctors' 4 RCTs n=150, RR 1.13, CI 0.69 to 1.86; nurses 4RCTs 
n=146, RR 1.23, CI 0.82 to 1.86). Molindone is no more or less likely than 
typical drugs to cause movement disorders, but it does cause significantly more 
weight loss (2RCTs n=60 RR 2.78, CI 1.10 to 6.99, NNH 5 CI 2 to 77).
AUTHORS' CONCLUSIONS: The strength of the evidence relating to this compound is 
limited, owing to small sample size, poor study design, limited outcomes and 
incomplete reporting. Molindone may be an effective antipsychotic but its 
adverse effect profile does not differ significantly from that of typical 
antipsychotics (apart from the event of weight loss). Data from this review 
suggest, at present, there is no evidence to suggest that it may have an 
atypical profile.