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First-Generation Versus Second-Generation Antipsychotics in Adults: Comparative Effectiveness

Slide: 19 of 35

Comparative Effectiveness of Haloperidol and SGAs for Treating Schizophrenia: Negative Symptoms

Haloperidol and second-generation antipsychotics (SGAs) were compared for effectiveness in treating negative symptoms of schizophrenia. The assessment instruments that were commonly used were the Scale for the Assessment of Negative Symptoms (SANS) and the Positive and Negative Syndrome Scale (PANSS).

When a statistically significant difference in effect was noted, the SGAs had a greater beneficial effect than haloperidol. Olanzapine specifically demonstrated a clinically significant greater benefit than haloperidol.

Statistically significant differences were found between haloperidol and aripiprazole (mean difference [MD] = 0.8; 95-percent confidence interval [95% CI] = 0.14 to 1.46; data from 3 randomized controlled trials [RCTs]); the strength of evidence for this finding was moderate. The difference between haloperidol and olanzapine on the PANSS was statistically and clinically significant, with moderate strength of evidence (MD = 1.06; 95% CI = 0.46 to 1.67; data from 14 RCTs). The difference between haloperidol and olanzapine on the SANS was statistically and clinically significant, with moderate strength of evidence (MD = 1.7;, 95% CI = 1.57 to 2.02; data from 5 RCTs). The difference between haloperidol and risperidone on the PANSS was statistically significant, with moderate strength of evidence (MD = 0.60; 95% CI =10.01 to 1.20; data from 20 RCTs). The difference between haloperidol and risperidone on the SANS was statistically significant, with moderate strength of evidence (MD = 0.58; 95% CI = 0.37 to 0.80; data from 4 RCTs). No statistically significant difference was found between haloperidol and quetiapine on the PANSS in four RCTs, between haloperidol and ziprasidone on the PANSS in three RCTs, and between haloperidol and clozapine on the PANSS and the SANS in two RCTs each.