A systematic review of atypical antipsychotic drugs in schizophrenia

Abstract

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Randomised controlled trials of conventional antipsychotic versus new atypical drugs, and new atypical drugs versus clozapine, in people with schizophrenia responding poorly to, or intolerant of, current drug treatment

“…A recent systematic review suggests that the conclusions that could be drawn about the relative effectiveness of the newer antipsychotics were limited because of problems with the validity of the trials in terms of inclusion and exclusion criteria, dose used, sample size and duration of trials, outcome measures used and methods of reporting symptoms. 32 In addition, the majority of trials compare the newer atypicals to haloperidol, a drug not widely used in Europe or the UK. The side-effect profile of haloperidol, particularly used at high doses, may not be representative of that found with other typical antipsychotics.…”

The clinical effectiveness and cost-effectiveness of testing for cytochrome P450 polymorphisms in patients with schizophrenia treated with antipsychotics: a systematic review and economic evaluation

“…37 It produces few acute EPS and has a lower incidence of tardive dyskinesia (TD) than other antipsychotics, although other ADRs include sedation, hypersalivation and hypertension. [44][45][46] Regarding efficacy, the HTA review of atypical antipsychotics in schizophrenia 47 noted that evidence for the effectiveness of the atypicals compared with typicals was 'in general of poor quality, based on short term trials and difficult to generalise to the whole population of people with schizophrenia'. The more recent Clinical Antipsychotic Trials in Intervention Effectiveness (CATIE) 43 and Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS) trials 48 have led the chief investigators of these trials to conclude that typical antipsychotics are as good as atypical antipsychotics for many patients.…”

Neurological complications of psychiatric drugs: clinical features and management

“…Several meta-analyses of RCTs have shown that atypical antipsychotics are less likely to cause EPS than conventional agents (Bagnall et al, 2003;Geddes et al, 2000). The EPS advantage of the atypical antipsychotics was the major reason why the National Institute of Clinical Excellence (NICE) Schizophrenia Guideline in the UK recommended that atypical antipsychotics should be first line drugs in the treatment of those with newly diagnosed schizophrenia and that patients treated with conventional antipsychotics who have unacceptable EPS should be switched to an atypical agent (National Institute for Clinical Excellence, 2002).…”