Atypical antipsychotics in the treatment of schizophrenia: systematic overview and meta-regression analysis

@article{Geddes2000AtypicalAI,
  title={Atypical antipsychotics in the treatment of schizophrenia: systematic overview and meta-regression analysis},
  author={John R. Geddes and Nick Freemantle and Paul J. Harrison and Paul E. Bebbington},
  journal={BMJ : British Medical Journal},
  year={2000},
  volume={321},
  pages={1371 - 1376}
}
Abstract Objective: To develop an evidence base for recommendations on the use of atypical antipsychotics for patients with schizophrenia. Design: Systematic overview and meta-regression analyses of randomised controlled trials, as a basis for formal development of guidelines. Subjects: 12 649 patients in 52 randomised trials comparing atypical antipsychotics (amisulpride, clozapine, olanzapine, quetiapine, risperidone, and sertindole) with conventional antipsychotics (usually haloperidol or… Expand
Meta-analysis of drop-out rates in randomised clinical trials, comparing typical and atypical antipsychotics in the treatment of schizophrenia
TLDR
A significant positive effect was detected in terms of the outcome of treatment discontinuation for atypical versus typical medication, though only where the use of flexible rather than fixed doses (closer to an experimental control situation) was possible. Expand
Efficacy of atypical v. typical antipsychotics in the treatment of early psychosis: meta-analysis
TLDR
Meta-analyses of randomised controlled trials in the early phase of psychosis looking at long-term discontinuation rates, short-term symptom changes, weight gain and extrapyramidal side-effects found no evidence for differences in efficacy between atypical and typical antipsychotics, but there was a clear difference in the side-effect profile. Expand
Time to discontinuation of atypical versus typical antipsychotics in the naturalistic treatment of schizophrenia
TLDR
In the usual care of schizophrenia patients, time to medication discontinuation for any cause appears significantly longer for atypical than typical antipsychotics regardless of the Typical antipsychotic potency level. Expand
Antipsychotic drugs for the acute treatment of patients with a first episode of schizophrenia: a systematic review with pairwise and network meta-analyses.
TLDR
Haloperidol seems to be a suboptimum treatment option for acute treatment of first-episode schizophrenia, but a systematic review with pairwise and network meta-analyses found little difference between second-generation antipsychotics. Expand
A review of atypical antipsychotic drugs versus conventional medication in schizophrenia
TLDR
Differences in clinical effectiveness and tolerability between conventional and atypical antipsychotic agents are described and some of the more significant adverse effects including tardive dyskinesia, weight gain, diabetes and sudden death are discussed. Expand
Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis
TLDR
A Bayesian-framework, multiple-treatments meta-analysis of randomised controlled trials to compare 15 antipsychotic drugs and placebo in the acute treatment of schizophrenia found all drugs were significantly more effective than placebo. Expand
Current therapy issues and unmet clinical needs in the treatment of schizophrenia: a review of the new generation antipsychotics
TLDR
The results from clinical trials suggest that atypical agents improve negative and affective symptoms, and cognitive functioning more than typical antipsychotics, but that the pattern of effects on these domains, as well as on suicidality, appears to differ. Expand
Antipsychotics and Schizophrenia: From Efficacy and Effectiveness to Clinical Decision-Making
TLDR
Past efficacy trials have strongly supported the position that SGAs are superior to FGAs in the treatment of schizophrenia and in side effect profile, and two large independent effectiveness trials have offered a strong challenge to these claims. Expand
A systematic review of meta-analyses of the efficacy of oral atypical antipsychotics for the treatment of adult patients with schizophrenia
  • L. Citrome
  • Medicine
  • Expert opinion on pharmacotherapy
  • 2012
TLDR
There is heterogeneity among the atypical antipsychotic agents in terms of efficacy, with clozapine evidencing consistent superiority over typical antipsychotics, trailed behind by olanzapine and risperidone, and meta-analyses generally do not support efficacy differences between the other atypicals compared with the older typical agents. Expand
Atypical Antipsychotics as First-Line Treatments for Schizophrenia
TLDR
Current guidelines recommend the use of atypical antipsychotics as first-line treatments in a wide range of patients with schizophrenia, despite significant caveats regarding the quality of evidence to support use of these drugs in general. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 29 REFERENCES
Efficacy and extrapyramidal side-effects of the new antipsychotics olanzapine, quetiapine, risperidone, and sertindole compared to conventional antipsychotics and placebo. A meta-analysis of randomized controlled trials
TLDR
All of the 4 new drugs are more effective than placebo, but the magnitude of the effect is only moderate, and all new antipsychotics are associated with less frequent use of antiparkinson medication than haloperidol. Expand
Atypical antipsychotics in the treatment of schizophrenia
  • R. Kerwin
  • Medicine
  • BMJ : British Medical Journal
  • 2001
TLDR
The team's draft report in July 1999 suggests that the correlation between effect difference and control dose of haloperidol may be an artefact of including the different atypical antipsychotics in a single analysis. Expand
Risperidone in the treatment of schizophrenia: a meta-analysis of randomized controlled trials.
  • F. Song
  • Psychology, Medicine
  • Journal of psychopharmacology
  • 1997
TLDR
It was concluded that the short-term efficacy of risperidone is comparable to other neuroleptics in the treatment of schizophrenia, and is associated with significantly fewer EPS than conventional neurolePTics (mainly haloperidol). Expand
Clozapine versus typical neuroleptic medication for schizophrenia.
TLDR
Clozapine treatment was more acceptable in long-term treatment than conventional antipsychotic drugs but did not differ from acceptability of high-potency neuroleptics such as haloperidol in terms of clinical improvement. Expand
Quetiapine for schizophrenia.
TLDR
Quetiapine is as potent as chlorpromazine and haloperidol as regards global and mental state but it may cause higher incidences of dry mouth and sleepiness and side effects such as dizziness and dry mouth are more prevalent in the quetiAPine treated group. Expand
Risperidone in the treatment of schizophrenia: a meta-analysis of randomized controlled trials
This study evaluates the relative effectiveness and side-effects of risperidone as compared with conventional neuroleptics in the treatment of schizophrenia, by meta-analysis of 11 double-blind,Expand
Risperidone versus typical antipsychotic medication for schizophrenia.
TLDR
Risperidone appears to have little or no additional effect on the positive and negative symptoms of schizophrenia but did have less tendency to cause movement disorders, largely in comparison with haloperidol. Expand
Antipsychotic-induced weight gain: a comprehensive research synthesis.
TLDR
Among the newer antipsychotic agents, clozapine appears to have the greatest potential to induce weight gain, and ziprasidone the least, and the differences among newer agents may affect compliance with medication and health risk. Expand
Randomised double-blind comparison of the incidence of tardive dyskinesia in patients with schizophrenia during long-term treatment with olanzapine or haloperidol.
TLDR
The results indicated a significantly lower risk of tardive dyskinesia with olanzapine than with haloperidol. Expand
Antipsychotic drugs: is more worse? A meta-analysis of the published randomized control trials.
TLDR
No incremental clinical improvement was found at doses above 375 mg equivalent of chlorpromazine, while a significant increase in adverse reactions was observed. Expand
...
1
2
3
...