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No differences in efficacy of atypical and typical antipsychotics in early psychosis, but side effects differ

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Are atypical antipsychotics any more effective or safe than typical antipsychotics?


Primary outcome: discontinuation for any cause at 12 months (where discontinuation at 12 months was not reported, figures for between 6 and 24 months were used). Secondary outcomes: symptoms at 12 weeks (where not reported, figures for between 6 and 18 weeks were used; where a study included more than one symptom measure, the Positive and Negative Symptom Scale was the preferred scale for inclusion in the analysis, followed by the Brief Psychiatric Rating Scale and then any other validated scale), and weight gain and extrapyramidal side effects at the time of the last observation.



Systematic review with meta-analysis.

Data sources

Cochrane CENTRAL, EMBASE, MEDLINE and PsycINFO were searched from inception to January 2009. Additional references were identified by hand searches of reference lists and reviews, and of conference abstracts. Two authors selected studies for exclusion and extracted data. Authors were contacted if data were missing.

Study selection and analysis

Randomised controlled trials (RCTs) comparing atypical versus typical antipsychotics in people in the early phase of psychosis and assessing the outcomes of interest …

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  • Source of funding The corresponding author received a fellowship from the National Institute of Health Research, UK.


  • Competing interests TSS has received consulting fees from Janssen. LFJ has received research funding from GSK and Novartis, and consulting fees from AstraZeneca.

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