New generation antipsychotics versus low-potency conventional antipsychotics: a systematic review and meta-analysis
The LancetPublished 1 May 2003
Stefan Leucht, Kristian Wahlbeck, Johannes Hamann, Werner Kissling
Citations727
SJR quartileQ1
SJR score12.11
SNIP22.72
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TL;DR
New generation drugs were moderately more efficacious than low-potency antipsychotics, largely irrespective of the comparator doses used, and potential advantages in efficacy of the new generation drugs should be a factor in clinical treatment decisions to use these rather than conventional drugs.
Abstract
Optimum doses of low-potency conventional antipsychotics might not induce more EPS than new generation drugs. Potential advantages in efficacy of the new generation drugs should be a factor in clinical treatment decisions to use these rather than conventional drugs.
Keywords
MedicineEconomics, Econometrics and Finance
BMJBias in meta-analysis detected by a simple, graphical test
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Funnel plots, plots of the trials' effect estimates against sample size, are skewed and asymmetrical in the presence of publication bias and other biases Funnel plot asymmetry, measured by regression analysis, predicts discordance of results when meta-analyses are compared with single large trials.
Controlled Clinical TrialsMeta-analysis in clinical trials
39,316 Citations1986Rebecca DerSimonian, Nan M. Laird
This paper examines eight published reviews each reporting results from several related trials in order to evaluate the efficacy of a certain treatment for a specified medical condition and suggests a simple noniterative procedure for characterizing the distribution of treatment effects in a series of studies.
Controlled Clinical TrialsAssessing the quality of reports of randomized clinical trials: Is blinding necessary?
17,565 Citations1996Alejandro R. Jadad, R Andrew Moore +5 more
An instrument to assess the quality of reports of randomized clinical trials (RCTs) in pain research is described and its use to determine the effect of rater blinding on the assessments of quality is described.
Archives of General PsychiatryClozapine for the Treatment-Resistant Schizophrenic
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In this relatively brief study, the apparently increased comparative risk of agranulocytosis requires that the use of clozapine be limited to selected treatment-resistant patients.
DrugsPentoxifylline
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Pentoxifylline offers a well-tolerated and effective alternative to the treatment options available for patients with peripheral vascular disease and may also prove useful in vaso-occlusive crises of sickle cell disease, some hearing disorders, disorders of eye circulation, high altitude sickness and asthenozoospermia.
International Journal of Group PsychotherapyComprehensive Textbook of Psychiatry
1,322 Citations1994Emily Stein, Hillel I. Swiller
BMJAtypical antipsychotics in the treatment of schizophrenia: systematic overview and meta-regression analysis
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There is no clear evidence that atypical antipsychotics are more effective or are better tolerated than conventional antipsychotic drugs.
ScienceAntipsychotic Drugs: Direct Correlation Between Clinical Potency and Presynaptic Action on Dopamine Neurons
869 Citations1975Philip Seeman, Teresa Lee
Compared to the inhibition of [3-H] dopamine release, much higher neuroleptic concentrations were needed to inhibit the electrically stimulated release of other neurotransmitters--[3- H] acetylcholine, [3,H-a1 (gamma-aminobutyric acid).
Archives of General PsychiatrySignificance of Neuroleptic Dose and Plasma Level in the Pharmacological Treatment of Psychoses
550 Citations1988Ross J. Baldessarini
Assessment of immediate and later follow-up treatment of psychotic patients indicates that moderate doses are adequate for most patients, and moderate doses of neuroleptics appear, on average, to be about as effective as, and probably safer than, the larger doses that have been popular in the United States in recent years.
American Journal of PsychiatryRelapse Prevention in Schizophrenia With New-Generation Antipsychotics: A Systematic Review and Exploratory Meta-Analysis of Randomized, Controlled Trials
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Overall, the currently available data suggest that new-generation antipsychotic drugs have the potential to reduce relapse rates.
American Journal of PsychiatryAmisulpride, an Unusual “Atypical” Antipsychotic: A Meta-Analysis of Randomized Controlled Trials
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These results cast some doubt on the notion that combined 5-HT(2)/D(2) antagonism is the reason that the newer antipsychotic medications are effective for negative symptoms and have fewer extrapyramidal side effects.
BMJContent and quality of 2000 controlled trials in schizophrenia over 50 years
364 Citations1998B. Thornley, Clive E Adams
The drug regulatory authorities should stipulate that the results of both explanatory and pragmatic trials are necessary before a compound is given a licence for everyday use, and much scope for well planned, conducted, and reported trials is left.
Journal of Clinical PsychopharmacologyThe Risks and Benefits of Clozapine versus Chlorpromazine
303 Citations1987James L. Claghorn, Gilbert Honigfeld +5 more
It is suggested that clozapine is well tolerated and may be therapeutically superior to chlorpromazine in treating psychotic behavior and agranulocytosis potential can be minimized by frequent white blood cell counts and removing nonresponding patients from treatment prior to the peak risk period.
Acta Psychiatrica ScandinavicaA comparison of quetiapine and chlorpromazine in the treatment of schizophrenia
252 Citations1997J. Peuskens, C.G.G. Link
The quetiapine group had a lower incidence of adverse events than the chlorpromazine group, and a low incidence of treatment‐emergent extrapyramidal symptoms, which support the preclinical profile of quetuapine as an atypical antipsychotic agent.
American Journal of PsychiatryOlanzapine Compared With Chlorpromazine in Treatment-Resistant Schizophrenia
242 Citations1998Robert R. Conley, Carol A. Tamminga +8 more
Olanzapine and chlorpromazine showed similar efficacy, and the total amount of improvement with either drug was modest, and Olanzapine-treated patients had fewer side effects than chlor Promazine- treated patients.
Archives of General PsychiatryClozapine, Chlorpromazine, and Placebo in Newly Hospitalized, Acutely Schizophrenic Patients
145 Citations1979Baron Shopsin
The data suggest that clozapine in the present population of newly admitted, acutely psychotic schizophrenic individuals, and in the doses employed, was more effective in overall improvement response, discharge rate, and ameliorating discrete symptoms across the different objective rating scales used than was chlorpromazine (Thorazine) hydrochloride.
Psychological MedicineAntipsychotic drugs: is more worse? a meta-analysis of the published randomized control trials
131 Citations1994Paola Bollini, S. Pampallona +3 more
No incremental clinical improvement was found at doses above 375 mg equivalent of chlorpromazine, while a significant increase in adverse reactions was observed.
Journal of Clinical PsychopharmacologyAntipsychotic and Anxiolytic Properties of Risperidone, Haloperidol, and Methotrimeprazine in Schizophrenic Patients
117 Citations1996Olivier Blin, J.-M. Azorin +1 more
R risperidone is an effective antipsychotic and anxiolytic agent in schizophrenic patients and clinical improvement, defined a priori as a 20% reduction in total Positive and Negative Syndrome Scale scores at end point, was attained.
The Journal of Clinical PsychiatryThe Efficacy and Safety of Clozapine Versus Chlorpromazine in Geriatric Schizophrenia
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PsychopharmacologyThe effect of MK-801 and other antagonists of NMDA-type glutamate receptors on brain-stimulation reward
75 Citations1989L.J. Herberg, I.C. Rose
The behavioural stimulant effects of MK-801 appear to be an intrinsic and essential feature of selective NMDA antagonists, and these effects differ qualitatively and quantitatively from the well-known facilitatory effects of dopamine-dependent stimulants.
PubMedClozapine versus chlorpromazine for the treatment of schizophrenia: preliminary results from a double-blind study.
70 Citations1979Gelenberg Aj, Doller Jc
Clozapine appeared to be at least as effective as chlorpromazine without producing any extrapyramidal reactions, demonstrating that a drug can be effective antipsychotic without producing neurologic reactions.
International Clinical PsychopharmacologyA double-blind comparative study of clozapine versus chlorpromazine on Chinese patients with treatment-refractory schizophrenia
61 Citations1997C.-J. Hong, J‐Y. Chen +2 more
Acta Psychiatrica ScandinavicaA double blind comparative study of remoxipride and thioridazine in the acute phase of schizophrenia
59 Citations1988Robin G. McCreadie, Norman A. Todd +7 more
There was no statistically significant between‐drug difference in improvement in mental state, as measured by the Brief Psychiatric Rating Scale, although the trend favoured thIORidazine; global assessment of illness severity at the last rating also, favoured thioridazine.
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Australian & New Zealand Journal of PsychiatryDouble-Blind Comparison of Clozapine with Chlorpromazine in Acute Schizophrenic Illness
46 Citations1976Edmond Chiu, Graham D. Burrows +1 more
Factor Analysis of ratings in 9 matched pairs indicates that Clozapine, at 300 mg.
Acta Psychiatrica ScandinavicaA placebo‐controlled clinical trial of remoxipride and chlorpromazine in newly admitted schizophrenic patients with acute exacerbation
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It was found that remoxipride was better in patients who had previously responded well to neuroleptics and on the BPRS measures of positive symptoms (hallucinatory behaviour and thinking disturbance factor), while chlorpromazine was found to be significantly better on the dropout rate due to inefficacy, Clinical Global Impression of severity of illness and Brief Psychiatric Rating Scale (BPRS).
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The overall therapeutic efficacy was good, and it was not possible to distinguish one group from the other, i.e. both substances were equally effective, judged by means of the psychopathometric tools that were at the authors' disposal.
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