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Second generation antipsychotics reduce treatment discontinuation rates compared with haloperidol

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QUESTION

Question:

What is the relative efficacy of low dose haloperidol and second generation antipsychotic (SGA) drugs for first episode schizophrenia?

Patients:

498 adults (aged 18–40 years) with a first episode of DSM-IV schizophrenia, schizophreniform disorder, or schizoaffective disorder (assessed using the Mini International Neuropsychiatric Interview plus). Main exclusions: positive symptoms starting over 2 years previously; use of antipsychotic drugs for more than 2 weeks in the preceding year, or for 6 weeks at any time; or known intolerance or contraindication to study drugs.

Setting:

50 sites in 13 European countries and Israel; recruitment December 2002 to January 2006.

Intervention:

Low dose haloperidol (1–4 mg/day) or one of four SGAs: amisulpride (200–800 mg/day), olanzapine (5–20 mg/day), quetiapine (200–750 mg/day), or ziprasidone (40–160 mg/day). All drugs were given orally.

Outcomes:

Primary outcome: rate of treatment discontinuation for any cause (defined as use of a dose of study drug either higher or lower than …

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