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Old versus new: weighing the evidence between the first- and second-generation antipsychotics

Published online by Cambridge University Press:  16 April 2020

John M. Davis*
Affiliation:
Department of Psychiatry (M/C 912), University of Illinois at Chicago, University of Maryland Psychiatric Research Center, 1601 W. Taylor Street, Chicago, IL, USA
Nancy Chen
Affiliation:
Department of Psychiatry (M/C 912), University of Illinois at Chicago, University of Maryland Psychiatric Research Center, 1601 W. Taylor Street, Chicago, IL, USA
*
*Corresponding author. E-mail address: [email protected] (J.M. Davis).
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Abstract

In our opinion the best guide to prescribing antipsychotics is the clinician’s experience with his patients and in particular the patient being treated. If treatment works, stick with it. We feel it is also important for the clinician to consider the evidence from well-controlled double-blind random-assignment studies because in “evidence-based medicine,” biases both known and unknown are controlled by blinding and randomization. The purpose of this paper is to summarize and discuss the evidence on efficacy. Choice of antipsychotic, in our opinion, is probably the most important decision that the clinician makes for the psychotic patient. This involves the choice of drug, its dose, balancing efficacy, side-effects and cost.

Type
Original article
Copyright
Copyright © Elsevier SAS 2005

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References

Allison, DB, Mentore, JL, Heo, M, Chandler, LP, Cappelleri, JC, Infante, MCet al.Antipsychotic-induced weight gain: a comprehensive research synthesis. Am J Psychiatr 1999;156:16861696.Google ScholarPubMed
Colonna, L, Saleem, P, Dondey-Nouvel, L, Rein, WLong-term safety and efficacy of amisulpride in subchronic or chronic schizophrenia. Amisulpride Study Group. Int Clin Psychopharmacol 2000;15:1322.CrossRefGoogle ScholarPubMed
Comprehensive meta-analysis. a computer program for research synthesis [computer program]. Englewood, NJ: Biostat; 1999.Google Scholar
Correll, CU, Leucht, S, Kane, JMLower risk for tardive dyskinesia associated with second-generation antipsychotics: a systematic review of 1-year studies. Am J Psychiatr 2004;161:414425.CrossRefGoogle ScholarPubMed
Csernansky, JG, Mahmoud, R, Brenne, RRisperidone-USA-79 Study Group A comparison of risperidone and haloperidol for the prevention of relapse in patients with schizophrenia. New Engl J Med 2002;346:1622.CrossRefGoogle ScholarPubMed
Davis, JM, Chen, NChoice of maintenance medication for schizophrenia. J Clin Psychiatr 2003;64:S24S33.Google Scholar
Davis, JM, Chen, N, Glick, IDA meta-analysis of the efficacy of second generation antipsychotics. Arch Gen Psychiatr 2003;60:553564.CrossRefGoogle ScholarPubMed
Davis, JM, Chen, NDose–response and dose equivalence of antipsychotics. J Clin Psychopharmacol 2004;24:192208.CrossRefGoogle ScholarPubMed
Duggan, L, Fenton, M, Dardennes, RM, El-Dosoky, A, Indran, SOlanzapine for schizophrenia. Cochrane review on CD-RO. Oxford, UK: Cochrane Library (Update Software, issue 2); 2002.Google Scholar
Fenton M, Morris S, De-Silva P, Bagnall A, Cooper SJ, Gammelin G, et al. Zotepine for schizophrenia. Cochrane Database Syst. Rev. 2002;2:CD001948.Google Scholar
Geddes, J, Freemantle, N, Harrison, P, Bebbington, PThe National Schizophrenia Guideline Development Group. Atypical antipsychotics in the treatment of schizophrenia systematic overview and meta-regression analysis. BM 2000;321:13711376.CrossRefGoogle ScholarPubMed
Halbreich, U, Kinon, BJ, Gilmore, JA, Kahn, LSElevated prolactin levels in patients with schizophrenia: mechanisms and related adverse effects. Psychoneuroendocrinolog 2003;28:S53S67.CrossRefGoogle ScholarPubMed
Hamner, MThe effects of atypical antipsychotics on serum prolactin levels. Ann Clin Psychiatr 2002;14:163173.CrossRefGoogle ScholarPubMed
Kennedy, E, Song, F, Hunter, R, Clarke, A, Gilbody, SRisperidone versus typical antipsychotic medication for schizophrenia. Cochrane review on CD-RO. Oxford, UK: Cochrane Library (Update Software, issue 2); 2002.Google Scholar
Leucht, S, Pitschel-Walz, G, Abraham, D, Kissling, WEfficacy and extrapyramidal side-effects of the new antipsychotics olanzapine, quetiapine, risperidone, and sertindole compared to conventional antipsychotics and placebo: a meta-analysis of randomized controlled trials. Schizophr Res 1999;35:5168.CrossRefGoogle ScholarPubMed
Leucht, S, Pitschel-Walz, G, Engel, RR, Kissling, WAmisulpride, an unusual “atypical” antipsychotic: a meta-analysis of randomized controlled trials. Am J Psychiatr 2002;159:180190.CrossRefGoogle ScholarPubMed
Leucht, S, Wahlbeck, K, Hamann, J, Kissling, WNew generation antipsychotics versus low-potency conventional antipsychotics: a systematic review and meta-analysis. Lance 2003;361:15811589.CrossRefGoogle ScholarPubMed
Leucht, S, Wagenpfeil, S, Hamann, J, Kissling, WAmisulpride is an “atypical” antipsychotic associated with low weight gain. Psychopharmacology (Berl 2004;173:112115.CrossRefGoogle ScholarPubMed
May, PR, Tuma, AH, Yale, C, Potepan, P, Dixon, WJSchizophrenia—a follow-up study of results of treatment. Arch Gen Psychiatr 1976;33:481486.CrossRefGoogle ScholarPubMed
MetaWin Statistical software for meta-analysis [computer program]. Version 2.0. Sunderland, MA: Sinauer Associates; 2000.Google Scholar
SAS Institute Inc Wang, MC, Bushman, BJIntegrating results through meta-analytic review using SAS softwar Cary, NC: SAS Institute Inc.; 1999.Google Scholar
Srisurapanont, M, Disayavanish, C, Taimkaew, KQuetiapine for schizophrenia. In: Cochrane review on CD-RO Oxford, UK: Cochrane Library (Update Software, issue 2); 2002.Google Scholar
Wahlbeck, K, Cheine, M, Essali, MAClozapine versus typical neuroleptic medication for schizophrenia. In: Cochrane review on CD-RO Oxford, UK: Cochrane Library (Update Software, issue 2); 2002.Google Scholar
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