Risperidone versus clozapine in treatment-resistant schizophrenia: A randomized pilot study

Wahlbeck, Kristian; Cheine, Maxim V; Tuisku, Katinka; Ahokas, Antti; Joffe, Grigori; Rimón, Ranan

doi:10.1016/s0278-5846(00)00118-4

Cited by 63 publications

(45 citation statements)

References 15 publications

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“…In four studies (Bondolfi 1998, 110 Breier 1999, 112 Wahlbeck 2000, 113 Chowdhury 1999 71 ), no differences were found between groups for the outcome 'not improved' (defined as less than 20% improvement on the BPRS or PANSS scales). In three studies (Bondolfi 1998, Anand 1998, 111 Wahlbeck 2000), no differences were found between groups for the outcome 'deterioration in mental state or relapse'.…”

Section: Mental Statementioning

confidence: 98%

“…Removing studies with more than 25% attrition (Anand 1998 (26%), 111 Wahlbeck 2000 (35%), 113 Beasley 1999 (40%) 77 ) from pooled estimates made no substantial difference to the results.…”

Section: Sensitivity Analysesmentioning

confidence: 99%

“…In 11 studies (Leon 1974, 83 Gerlach 1974, 84 Gerlach 1975, 85 Honigfeld 1984, 88 Erlandsen 1981, 93 Ciurezu 1976, 94 Shopsin 1979, 96 Kane 1988, 99 Gordon 1996, 104 Rosenheck 1997, 105 Breier 1999 112 ), ITT analysis was undertaken in terms of both efficacy and side-effects. The method using 'last observation carried forward' was declared in three studies , 113 Beasley 1999, 77 Bondolfi 1998 110 ).…”

Section: Quality Of Included Studiesmentioning

confidence: 99%

“…In six studies (Klieser 1994, 90 Bondolfi 1998, 110 Anand 1998, 111 Breier 1999, 112 Wahlbeck 2000, 113 Chowdhury 1999 71 ), people taking clozapine were found to be no more or less likely to leave the studies early than those taking risperidone. In one study , no difference was found between groups for the outcome 'patient dissatisfaction'.…”

Section: Acceptability Of Treatmentmentioning

confidence: 99%

“…In the original review, 23 studies were identified for inclusion: Blin 1996, 251 Borison 1991, 252 Bouchard 1998, 253 Ceskova 1993, 254 Chouinard 1993, 255 Claus 1991, 256 Emsley 1995, 257 Hoyberg 1993, 258 Huttunen 1995, 259 Mahmoud 1998, 260 Marder 1994, 116 Mesotten 1991, 261 Min 1993, 262 Peuskens 1995, 263 Fleurot 1997, 62 Bondolfi 1998, 110 Anand 1998, 111 Breier 1999, 112 Wahlbeck 2000, 113 Tran 1997, 171 Klieser 1996, 264 Jones 1998, 193 Gureje 1998. 186 Data extraction sheets for these studies are presented in appendix 3.…”

Section: Old Rctsmentioning

confidence: 99%

See 4 more Smart Citations

A systematic review of atypical antipsychotic drugs in schizophrenia

Bagnall

Jones

Ginnelly

et al. 2003

Health Technol Assess

148

114

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTAA systematic review of atypical antipsychotic drugs in schizophrenia NHS R&D HTA ProgrammeT he NHS R&D Health Technology Assessment (HTA) Programme was set up in 1993 to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and provide care in the NHS.The research reported in this monograph was commissioned by the HTA Programme on behalf of the National Institute for Clinical Excellence (NICE). Technology assessment reports are completed in a limited time to inform the appraisal and guidance development processes managed by NICE. The review brings together evidence on key aspects of the use of the technology concerned. However, appraisals and guidance produced by NICE are informed by a wide range of sources.The research reported in this monograph was funded as project number 00/20/01.The views expressed in this publication are those of the authors and not necessarily those of the HTA Programme, NICE or the Department of Health. The editors wish to emphasise that funding and publication of this research by the NHS should not be taken as implicit support for any recommendations made by the authors. Criteria for inclusion in the HTA monograph seriesReports are published in the HTA monograph series if (1) they have resulted from work commissioned for the HTA Programme, and (2) they are of a sufficiently high scientific quality as assessed by the referees and editors.Reviews in Health Technology Assessment are termed 'syst...

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Section: Mental Statementioning

confidence: 98%

“…Removing studies with more than 25% attrition (Anand 1998 (26%), 111 Wahlbeck 2000 (35%), 113 Beasley 1999 (40%) 77 ) from pooled estimates made no substantial difference to the results.…”

Section: Sensitivity Analysesmentioning

confidence: 99%

Section: Quality Of Included Studiesmentioning

confidence: 99%

Section: Acceptability Of Treatmentmentioning

confidence: 99%

Section: Old Rctsmentioning

confidence: 99%

See 3 more Smart Citations

A systematic review of atypical antipsychotic drugs in schizophrenia

Bagnall

Jones

Ginnelly

et al. 2003

Health Technol Assess

148

114

View full text Add to dashboard Cite

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A Meta-analysis of the Efficacy of Second-Generation Antipsychotics

Davis

Chen²,

Glick³

2003

Arch Gen Psychiatry

870

486

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Efficacy, Acceptability, and Tolerability of Antipsychotics in Treatment-Resistant Schizophrenia

et al. 2016

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In treatment-resistant schizophrenia, clozapine is considered the standard treatment. However, clozapine use has restrictions owing to its many adverse effects. Moreover, an increasing number of randomized clinical trials (RCTs) of other antipsychotics have been published. OBJECTIVE To integrate all the randomized evidence from the available antipsychotics used for treatment-resistant schizophrenia by performing a network meta-analysis. DATA SOURCES MEDLINE, EMBASE, Biosis, PsycINFO, PubMed, Cochrane Central Register of Controlled Trials, World Health Organization International Trial Registry, and clinicaltrials.gov were searched up to June 30, 2014. STUDY SELECTION At least 2 independent reviewers selected published and unpublished single-and double-blind RCTs in treatment-resistant schizophrenia (any study-defined criterion) that compared any antipsychotic (at any dose and in any form of administration) with another antipsychotic or placebo. DATA EXTRACTION AND SYNTHESIS At least 2 independent reviewers extracted all data into standard forms and assessed the quality of all included trials with the Cochrane Collaboration's risk-of-bias tool. Data were pooled using a random-effects model in a Bayesian setting. MAIN OUTCOMES AND MEASURES The primary outcome was efficacy as measured by overall change in symptoms of schizophrenia. Secondary outcomes included change in positive and negative symptoms of schizophrenia, categorical response to treatment, dropouts for any reason and for inefficacy of treatment, and important adverse events. RESULTS Forty blinded RCTs with 5172 unique participants (71.5% men; mean [SD] age, 38.8 [3.7] years) were included in the analysis. Few significant differences were found in all outcomes. In the primary outcome (reported as standardized mean difference; 95% credible interval), olanzapine was more effective than quetiapine (−0.29; −0.56 to −0.02), haloperidol (−0. 29; −0.44 to −0.13), and sertindole (−0.46; −0.80 to −0.06); clozapine was more effective than haloperidol (−0.22; −0.38 to −0.07) and sertindole (−0.40; −0.74 to −0.04); and risperidone was more effective than sertindole (−0.32; −0.63 to −0.01). A pattern of superiority for olanzapine, clozapine, and risperidone was seen in other efficacy outcomes, but results were not consistent and effect sizes were usually small. In addition, relatively few RCTs were available for antipsychotics other than clozapine, haloperidol, olanzapine, and risperidone. The most surprising finding was that clozapine was not significantly better than most other drugs. CONCLUSIONS AND RELEVANCE Insufficient evidence exists on which antipsychotic is more efficacious for patients with treatment-resistant schizophrenia, and blinded RCTs-in contrast to unblinded, randomized effectiveness studies-provide little evidence of the superiority of clozapine compared with other second-generation antipsychotics. Future clozapine studies with high doses and patients with extremely treatment-refractory schizophrenia might be most promising to change the current evid...

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Risperidone versus clozapine in treatment-resistant schizophrenia: A randomized pilot study

Cited by 63 publications

References 15 publications

A systematic review of atypical antipsychotic drugs in schizophrenia

A systematic review of atypical antipsychotic drugs in schizophrenia

A Meta-analysis of the Efficacy of Second-Generation Antipsychotics

Efficacy, Acceptability, and Tolerability of Antipsychotics in Treatment-Resistant Schizophrenia

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