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Review: second generation antipsychotics are a heterogeneous drug class

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QUESTION

Question:

Are second generation antipsychotic drugs more effective than first generation antipsychotic drugs for people with schizophrenia?

Outcomes:

Overall efficacy (changes in Positive and Negative Syndrome Scale or in Brief Psychiatric Rating Scale), positive, negative and depressive symptoms, quality of life and relapse rates. Other outcomes were extrapyramidal side effects, weight gain and sedation property.

METHODS

Design:

Systematic review and meta-analysis.

Data sources:

The Cochrane Schizophrenia Group Trials Register, FDA website and MEDLINE, from August 2005 to October 2006. Previous reviews were also used to identify additional references.

Study selection and analysis:

Only double blind randomised controlled trials (RCTs), comparing first (FGA) and second (SGA) generation antipsychotic drugs in people with schizophrenia or related disorders were included. Main exclusions: single blind and open label trials and trials with inadequate randomisation. Data were independently extracted by two reviewers. Results of individual studies were combined and meta-analysed using a random effects model. Continuous data were reported as the standard mean difference Hedges’ adjusted g, and dichotomous outcomes as relative risks (RR), risk differences and number to treat (NNT) or number to harm. Heterogeneity was examined using the I2 statistic. Publication bias …

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