Sixty newly admitted acute schizophrenic patients were randomly assigned to a double-blind trial of metiapine with a maximum dose of 450 mg per day versus a maximum dose of 450 mg per day versus a maximum daily dose of 900 mg chlorpromazine per day. At the conclusion of the study, 21 patients in each group showed marked to moderate improvement. There were significantly more marked improvers in the metiapine group then the chlorpromazine group on the Physician's Posttreatment Global Impression. Evaluation by analysis of covariance of the Brief Psychiatric Rating Scale showed a significant difference between treatment groups favoring chlorpromazine on the item of blunted affect. The spectrum of side effects was similar in the two groups, except for six patients treated with metiapine who displayed tachycardia on the EKG. This pulse elevation was reflected in the group data and is probably dose related. In conclusion, both drugs appeared to be equally efficacious in the treatment of newly admitted acute schizophrenic patients.