Comparison of chlorpromazine versus morphine hydrochloride for treatment of neonatal abstinence syndrome

Aim: To compare the duration of treatment for neonatal abstinence syndrome (NAS) using chlorpromazine versus morphine hydrochloride. Methods: We compared two case series of term infants with NAS treated with either morphine hydrochloride (MH) or chlorpromazine (CP). Seventeen infants were treated with MH from 1998 to 1999, and 20 infants were managed with CP from 2000 to 2001. The duration of treatment was compared, and multivariate analysis was used to identify independent risk factors related to the duration of treatment. Results: Characteristics of the mothers (duration of drug addiction, abuse of other substances) and infants (birth weight, proportion breastfed) were similar in the two groups. The mean duration of CP treatment was 6 days (range 3.5-9 days), significantly fewer days than with MH treatment, which was 16 days (range 10-21 days; p < 0.001). There were fewer hospitalization days (11 days; range 9-14 days) for CP treatment compared with MH-treated infants (18 days; range 16-25 days). Treatment with CP was independently associated with shorter hospitalization time. Conclusion: CP appears to shorten the duration of NAS compared with MH. Larger prospective randomized trials are needed to confirm our findings.