Effectiveness of Antipsychotic Drugs for 24-Month Maintenance Treatment in First-Episode Schizophrenia

Abstract

These findings suggest that antipsychotic drugs can achieve equivalent effectiveness in maintenance treatment of first-episode schizophrenia through a well-organized case management program and family participation.

Clozapine as a first‐ or second‐line treatment in schizophrenia: a systematic review and meta‐analysis

“…Using our search methods, 1248 articles were found. Applying our inclusion and exclusion criteria reduced the number of relevant articles to fifteen , ten of which evaluated CLZ as a first‐line treatment , while five were clinical reports that evaluated CLZ as a second‐line treatment (Fig. ) .…”

“…Both case reports concluded CLZ was effective (there was no active comparator). Four trials (50%) provided summary statistics in line with CLZ being equally effective to other antipsychotics , while four trials (50%) pointed to increased efficacy of CLZ over other antipsychotics .…”

“…Six case reports , two articles with overlapping study populations , and two articles without data to analyze/no active comparator were excluded. From the five articles that remained, three compared clozapine vs. risperidone , one compared clozapine vs. chlorpromazine , and one compared clozapine vs. thioridazine . An overview of the studies can be found in Table .…”

“…We found that two studies included in our meta‐analysis were naturalistic. Another sensitivity analysis was therefore performed on CLZ vs. other antipsychotics only including randomized controlled trials , revealing no significant benefit of CLZ over the other antipsychotics (Hedges’ g = 0.169, P = 0.271, CI = −0.131–0.468; Figure , with no evidence of heterogeneity, Q = 1.729, I 2 = 0.00).…”

“…The primary outcome was treatment response on CLZ vs. any other antipsychotic, as defined by the authors in changes in positive, negative, or total symptoms on the PANSS, BPRS, or CGI. In most of the studies included in this systematic review, response was defined as 50% change on BPRS , while other studies (also) defined response as a CGI of ‘mild’ or less . One study used the Schedule for Affective Disorders and Schizophrenia – change (SADS‐C) version to identify treatment response .…”