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

Slide: 23 of 35

Comparative Effectiveness of FGAs and SGAs for Treatment of Schizophrenia: Other Comparisons (2 of 2)

The first-generation antipsychotic (FGA) chlorpromazine has been compared to the second-generation antipsychotic (SGA) clozapine in head-to--head trials. Clozapine provides better total scores than chlorpromazine using the Brief Psychiatric Rating Scale (BPRS).

All other comparisons of chlorpromazine with SGAs were insufficient to permit conclusions about comparative effectiveness.

When compared with chlorpromazine, clozapine was found to yield greater improvement in BPRS total scores. The mean difference was 8.4, and the 95-percent confidence interval ranged from 5.92 to 10.88. The result was from a pooled analysis of data from 6 randomized controlled trials.

The evidence was insufficient to analyze data for positive and negative symptoms and for general psychopathology.