Newer atypical antipsychotic medication versus clozapine for schizophrenia.

摘要: BACKGROUND Clozapine is an atypical antipsychotic drug, which claimed to have superior efficacy and cause fewer movement disorders. However, clozapine carries a significant risk of serious blood Newer antipsychotics are safer alternatives that might share the benefits clozapine. It thus interest compare effectiveness newer with OBJECTIVES To evaluate clinical effects drugs in comparison for schizophrenia. SEARCH STRATEGY Publications all languages were searched from following databases: Biological Abstracts/BIOSIS (1980-1999), The Cochrane Schizophrenia Group's Register Trials (1998), Library CENTRAL (Issue 4, 1999), EMBASE (1980-1998), MEDLINE (1966-1999), LILACS/CD-ROM PsycLIT/PsycINFO (1974-1999). also sought recent conference proceedings reference lists included papers. Authors trials manufacturers clozapine, iloperidone, olanzapine, quetiapine, remoxipride, risperidone, sertindole, ziprasidone zotepine contacted. SELECTION CRITERIA All randomised controlled comparing by independent assessment two reviewers. DATA COLLECTION AND ANALYSIS Data extracted independently Relative risks (RR) 95% confidence intervals (CI) homogenous dichotomous data calculated. A random model was used heterogeneous data. Where possible number needed treat (NNT) statistic 95%CI Weighted or standardised means calculated continuous Due small studies, sensitivity analyses funnel plot statistics not undertaken this version review. MAIN RESULTS current review includes eight studies (22 papers), three 4-6 weeks duration only one study more than 12 weeks' duration. seemed be broadly similar using global index trialists' definitions improvement, but result obtained relatively studies. patients, wide seen when their as measured symptom rating scales compared. Social functioning better patients on medication (risperidone) those finding based single underpowered trial has interpreted caution. showed adverse effect profile dissimilar: while produced fatigue, hypersalivation, nausea, orthostatic dizziness, new drugs, exception extrapyramidal symptoms. impact these patients' day-to-day quality life, service use, hospital admission, pharmacoeconomics measured. REVIEWER'S CONCLUSIONS equal tolerability yet demonstrated. Lack statistical power determine comparative makes it difficult judge whether effective, less effective equivalent. sufficient power, longer duration, measuring clinically important outcomes, assess true effectiveness, cost relation