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Second generation antipsychotics reduce dropout rates compared with first generation antipsychotics

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Question

Question:

Do second generation medications for schizophrenic disorders result in similar dropout rates to first generation treatments?

Outcomes:

Dropout, predictors of dropout rates (eg, trial duration, number of treatment groups, patient type, type of dosing, inpatients, dosage and study year).

Methods

Design:

Systematic review with meta-analysis.

Data sources:

Pubmed and the Cochrane Central Register of Controlled Trials were searched from 1990 to 2006.

Study selection and analysis:

Double blind randomised controlled trials comparing second generation antipsychotic medications versus each other, first generation antipsychotics or placebo in any adult population with a diagnosis of schizophrenia, schizoaffective or schizophreniform disorder were included. Eligible second generation drugs were risperidone, olanzapine, clozapine, quetiapine, amisulpride, ziprasidone, sertindole and aripiprazole. The proportions of patients who dropped out from each study group were calculated as well as the odds ratios and 95% CI for those studies that compared first and second generation drugs. Random effects meta-analysis was used to compare dropout rates, firstly for all studies and then for subgroups by study size (at least 30, 50 and 100 patients), dose (removing high doses), each second generation drug, inpatients, outpatients and studies of …

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