Quetiapine versus typical antipsychotic medications for schizophrenia

摘要: Background Quetiapine is a widely used atypical antipsychotic drug for schizophrenia that has been on the market over decade. However, It not clear how effects of quetiapine differ from typical antipsychotics. Objectives To review in comparison with antipsychotics treatment and schizophrenia-like psychosis. Search methods We searched Cochrane Schizophrenia Group Trials Register (March 2010), inspected references all identified studies. Selection criteria We included randomised control trials comparing oral drugs people or psychosis. Data collection analysis We extracted data independently. For dichotomous data, we calculated risk ratio (RR) 95% confidence intervals (CI) using random-effects model. We presented chosen outcomes 'Summary findings' table comparative risks where appropriate. continuous mean differences (MD) based assessed bias studies. Main results The includes 43 controlled (RCTs) 7217 participants. Most studies were China. The percentages participants leaving early similar (36.5% group 36.9% group) no significant difference between groups was apparent due to any reason (23 RCTs n = 3576 RR 0.91 CI 0.81 1.01, moderate quality evidence), however, fewer left adverse events (15 RCTs, 3010, 0.48 0.30 0.77). Overall global state (no clinically response; 16 1607, 0.96 0.75 1.23, evidence) there positive symptoms (PANSS subscore: 22 1934, MD 0.02 -0.39 0.43, evidence). General psychopathology equivocal general 18 1569, -0.20 -0.83 0.42) those allocated antipsychotics. statistically significantly more efficacious negative -0.82 -1.59 -0.04, this result highly heterogeneous driven by two small outlier high effect sizes. Without these studies, heterogeneity antipsychotics. Compared antipsychotics, might cause (9 1985, 0.76 0.64 0.90 number needed treat induce harm (NNTH) 10, 8 17), less abnormal ECG (2 165, 0.38 0.16 0.92, NNTH 8, 4 55), overall extrapyramidal (8 1,095, 0.17 0.09 0.32, 3, 3 specific including akathisia, parkinsonism, dystonia tremor. Moreover, it lower prolactin level (4 1034, -16.20 -23.34 -9.07, weight gain compared some short term 866, 0.52 0.34 0.80, 6 15). However, suicide attempt, suicide, death, QTc prolongation, low blood pressure, tachycardia, sedation, gynaecomastia, galactorrhoea, menstrual irregularity white cell count. Authors' conclusions Quetiapine may psychopathology. There are terms symptoms. causes ECG, effects, levels gain.