First-Generation Versus Second-Generation Antipsychotics in Adults: Comparative Effectiveness
Summary of Studies of Schizophrenia Included in the Comparative Effectiveness Review
Studies of efficacy, effectiveness, benefits, and adverse effects of antipsychotics as treatment for schizophrenia are reported in the clinical literature. There are few reports of comparative effectiveness studies of the newer second-generation antipsychotics asenapine, iloperidone, and paliperidone. Many different scales were used to assess outcomes, thus limiting the quantitative pooling of data in the comparative effectiveness review.
Among the studies included in the comparative effectiveness review, most comparisons evaluated the first-generation antipsychotic haloperidol (8 studies compared haloperidol with aripiprazole, 1 with asenapine, 11 with clozapine, 35 with olanzapine, 11 with quetiapine, 39 with risperidone, and 9 with ziprasidone). Twelve studies compared chlorpromazine to clozapine. Chlorpromazine was compared with olanzapine, quetiapine, and ziprasidone in one study each. Fluphenazine was compared with olanzapine in two studies and with quetiapine and risperidone in one study. Perphenazine was compared with aripiprazole in one study, with olanzapine in two studies, with quetiapine in one study, with risperidone in two studies, and with ziprasidone in one study. Trifluoperazine was compared with clozapine in one study. Thioridazine was compared with clozapine and risperidone in one study each.
- Abou-Setta AM, Mousavi SS, Spooner C, et al. First-Generation Versus Second-Generation Antipsychotics in Adults: Comparative Effectiveness. Comparative Effectiveness Review No. 63 (Prepared by the University of Alberta Evidence-based Practice Center under Contract No. 290-2007-10021). Rockville, MD: Agency for Healthcare Research and Quality; August 2012. AHRQ Publication No. 12-EHC054-EF. Available at www.effectivehealthcare.ahrq.gov/antipsychotics-adult.cfm.
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