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Review: 15 antipsychotic drugs are more effective than placebo for the treatment of schizophrenia, but vary in their tolerability

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Question

Question What is the comparative efficacy, risk of all-cause discontinuation and major side effects of antipsychotics used for the treatment of schizophrenia?

Outcomes The mean overall change in symptoms (primary outcome), all-cause discontinuation, weight gain, extrapyramidal side effects, prolactin increase, prolonged QT interval and sedation.

Methods

Design Systematic review and multiple-treatment meta-analysis.

Data sources Cochrane Schizophrenia Group's specialised register, MEDLINE, EMBASE, PsycINFO, CENTRAL and ClinicalTrials.gov were searched up to September 2012, supplemented by review of Food and Drug Administration and pharmaceutical company websites and reference lists of reviews.

Study selection and analysis Randomised controlled trials (single-blind at minimum) of 15 orally administered antipsychotic drugs used as monotherapy for the acute treatment of schizophrenia or related disorders (schizoaffective, schizophreniform or delusional disorder). Trials in stable patients, those with predominant negative symptoms, concomitant medical illnesses or treatment resistance were excluded. A multiple-treatment meta-analysis was performed. The standardised mean differences were calculated for continuous outcomes and ORs for …

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