First-Generation Versus Second-Generation Antipsychotics in Adults: Comparative Effectiveness
Comparative Effectiveness of Haloperidol and SGAs for Treating Schizophrenia: Global Ratings/Total Scores
Haloperidol and second-generation antipsychotics were compared for effectiveness in treating positive symptoms of schizophrenia. Commonly used assessment instruments were the Positive and Negative Syndrome Scale (PANSS), the Brief Psychiatric Rating Scale (BPRS), the Clinical Global Impressions–Improvement Subscale (CGI-I), and the CGI-Symptoms Subscale (CGI-S). Most comparisons resulted in findings of no statistically significant difference between haloperidol and a second-generation antipsychotic.
Olanzapine demonstrated a clinically significant greater benefit than haloperidol. Using the PANSS, in 14 randomized controlled trials (RCTs) the mean difference is 2.31 with a 95-percent confidence interval (95% CI) ranging from 0.44 to 4.18; the strength of evidence for this finding is moderate. Using the CGI-S, in seven RCTs the mean difference is 0.20 with a 95% CI ranging from 0.07 to 0.32; the strength of evidence for this finding is moderate. No statistically significant difference between olanzapine and haloperidol was noted by using the BPRS and the CGI-I; the strength of evidence for these findings is low.
In comparison with quetiapine, haloperidol provided a greater improvement in score on the CGI-S in four RCTs, with a mean difference of 0.23 and a 95% CI ranging from 0.42 to 0.04; the strength of evidence for this finding is moderate. No statistically significant difference was noted using the PANSS, BPRS, or CGI-I; the strength of evidence for these findings is low.
No statistically significant differences were noted for risperidone, ziprasidone, or clozapine compared with haloperidol.
- 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.
Your slide tray is being processed.