Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-26T01:20:18.206Z Has data issue: false hasContentIssue false
  • English
  • Français

Meta-analytic study of the benefits and risks of treating chronic schizophrenia with risperidone or conventional neuroleptics

Published online by Cambridge University Press:  16 April 2020

P Bech ,
JCJR Peuskens ,
SR Marder ,
G Chouinard ,
OJ Høyberg ,
MO Huttunen ,
O Blin  and
A Claus
P Bech
Affiliation:
Psychiatric Research Unit, Frederiksborg General Hospital, Hillered Sygehus, DK-3400, Hillerød, Denmark
JCJR Peuskens
Affiliation:
University Center St Jozef, Kortenberg, Belgium
SR Marder
Affiliation:
West Los Angeles VA Medical Center, Los Angeles, CA, US
G Chouinard
Affiliation:
Hôpital Louis-H Lafontaine, Montreal, Quebec, Canada
OJ Høyberg
Affiliation:
Department Of Psychiatry, Molde Hospital, Molde, Norway
MO Huttunen
Affiliation:
Department of Psychiatry, University of Helsinki, Finland
O Blin
Affiliation:
Hôapital de la Timone, Marseilles, France
A Claus
Affiliation:
University Psychiatric Hospital St Camillus, Birbeek, Belgium
Get access

Summary

Data from six randomised, controlled, comparative studies of risperidone and conventional neuroleptics (haloperidol, zuclopenthixol and perphenazine) in the treatment of 911 patients with chronic schizophrenia were analysed to estimate the benefits and risks of treatment. Efficacy and risk of treatment were assessed by means of the Positive and Negative Syndrome Scale (PANSS) and the Extrapyramidal Symptom Rating Scale (ESRS). An effect size (difference between treatments) was calculated from the PANSS and ESRS scores. The effect size of antipsychotic effect favoured risperidone (sizes ranged from 0.22 to 0.37 on the PANSS subscales), and the effect size of safety also favoured risperidone (sizes ranged from 0.18 to 0.36 on the ESRS). An analysis of the proportions of patients requiring antiparkinsonian medication produced an effect size of 0.37 (20% of risperidone patients and 38% of patients receiving a conventional neuroleptic required antiparkinsonian medication). These data indicate that risperidone is a more effective antipsychotic than the conventional agents and causes less severe extrapyramidal symptoms.

Keywords

meta-analysis schizophreniarisperidoneefficacytolerability
Type
Original article
Information
European Psychiatry , Volume 13 , Issue 6 , September 1998 , pp. 310 - 314
Copyright
Copyright © Elsevier, Paris 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 3rd ed rev (DSM-III-R) Washington: American Psychiatric Association; 1987.Google Scholar
Andreasen, NCOlsen, SANegative versus positive schizophrenia: definition and validation Arch Gen Psychiatry 1982; 39: 789–794CrossRefGoogle Scholar
Bech, PCialdella, PCitalopram in depression: meta-analysis of intended and unintended effects Int Clin Psychopharmacol 6suppl 51992 45–54CrossRefGoogle ScholarPubMed
Blin, OAzorin, JMBouhours, PAntipsychotic and anxiolytic properties of risperidone, haloperidol, and levomepromazine in schizophrenic patients J Clin Psychopharmacol 1996; 16: 38–44CrossRefGoogle ScholarPubMed
Borison, RLPathiraja, APDiamond, BIMeibach, RCRisperidone: clinical safety and efficacy in schizophrenia Psychopharmacol Bull 1992; 28: 213–218Google Scholar
Carman, JPeuskens, JVangeneugden, ARisperidone in the treatment of negative symptoms of schizophrenia: a meta-analysis Int Clin Psychophannacol 1995; 10: 207–213CrossRefGoogle ScholarPubMed
Chouinard, GRoss-Chouinard, AAnnable, LJones, BDExtrapyramidal Symptom Rating Scale Can J Neurol Sci 1980; 7: 233Google Scholar
Chouinard, GJones, BRemington, GBloom, DAddington, DMacEwan, GWet al.A Canadian multicenter placebo-controlled study of fixed doses of risperidone and haloperidol in the treatment of chronic schizophrenic patients J Clin Psychopharmacol 1993; 13: 25–40CrossRefGoogle ScholarPubMed
Claus, ABollen, JDe Cuyper, HEneman, MMalfroid, MPeuskens, JHeylen, SRisperidone versus haloperidol in the treatment of chronic schizophrenic inpatients: a multicentre double-blind comparative study Acta Psychiatr Scand 1992; 85: 295–305CrossRefGoogle ScholarPubMed
Cohen, JStatistical Power Analysis for the Behavioral Sciences Orlando: Academic Press; 1977.Google Scholar
Davis, JMJanicak, PGRisperidone: a new, novel (and better?) antipsychotic Psychiatr Ann 1996; 26: 78–87CrossRefGoogle Scholar
Glass, GVIntegrating findings: the meta-analysis of research Rev Educ Res 1977; 5: 351–379Google Scholar
Greenberg, RPBornstein, RFZborowski, MJFisher, SGreenberg, MDA meta-analysis of fluoxetine outcome in the treatment of depression J Nerv Ment Dis 192 1994 547–551CrossRefGoogle Scholar
Guy, W.Early Clinical Drug Evaluation (ECDEU) Assessment Manual Rockville: National Institute of Mental Health; 1976.Google Scholar
Høyberg, OJFensbo, CRemvig, JLingjaerde, OSloth-Nielsen, MSalvesen, IRisperidone versus perphenazine in the treatment of chronic schizophrenic patients with acute exacerbation Acta Psychiatr Scand 1993; 88: 395–402CrossRefGoogle Scholar
Huttunen, MOPieponnen, TRantanen, HLarmo, INyholm, RRaitasuo, VRisperidone versus zuclopenthixol in the treatment of acute schizophrenic episodes: a double-blind parallel-group trial Acta Psychiatr Scand 1995; 91: 271–277CrossRefGoogle ScholarPubMed
Kane, JMRisperidone Am J Psychiatry 1994; 151: 802–803Google ScholarPubMed
Kane, JHonigfeld, GSinger, JMeltzer, H.Clozaril Collaborative Study Group Clozapine for the treatment-resistant schizophrenic: a double-blind comparison with haloperidol Arch Gen Psychiatry 1988; 45: 789–796CrossRefGoogle Scholar
Kay, SRFiszbein, AOpler, LAThe Positive and Negative Syndrome Scale (PANSS) for schizophrenia Schizophr Bull 1987; 13: 261–276CrossRefGoogle Scholar
Leysen, JEGommeren, WEens, Ade Courcelles, D De ChaffoyStoof, JCJanssen, PAJThe biochemical profile of risperidone, a new antipsychotic J Pharmacol Exp Ther 1988; 247: 661–670Google ScholarPubMed
Lieberman, JAJohns, CAKane, JMRai, KClozapine-induced agranulocytosis: non-cross reactivity with other psychotropic drugs J Clin Psychiatry 1988; 49: 271–277Google ScholarPubMed
Marder, SRMeibach, RCRisperidone in the treatment of schizophrenia Am J Psychiatry 1994; 151: 825–835Google ScholarPubMed
Meltzer, HYMatsubara, SLee, JCClassification of typical and atypical antipsychotic drugs on the basis of dopamine D-1, D-2, and serotonin 2 pKi values J Pharmacol Exp Ther 1989; 251: 238–249Google Scholar
Möller, HJMüller, HBorison, RLSchooler, NRChouinard, GA path-analytical approach to differentiate between direct and indirect drug effects on negative symptoms in schizophrenic patients: a re-evaluation of the North American risperidone study Eur Arch Psychiatry Clin Neurosci 1995; 245: 45–49CrossRefGoogle ScholarPubMed
Overall, JEGorham, DRThe Brief Psychiatric Rating Scale Psychol Rep 1962; 10: 799–812CrossRefGoogle Scholar
Peuskens, JThe Risperidone Study Group Risperidone in the treatment of patients with chronic schizophrenia: a multinational, multi-centre, double-blind, parallel-group study versus haloperidol Br J Psychiatry 1995; 166: 712–726CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.