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

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Summary of Results: FGAs Versus SGAs for Treating Schizophrenia

Few differences were found in comparisons of the first-generation antipsychotic haloperidol with the second-generation antipsychotics. Clinical significance, defined as at least a 20-percent difference between interventions on an individual scale, was rarely found.

When compared with haloperidol, olanzapine may provide clinically significant, greater improvement in negative symptoms (Positive and Negative Syndrome Scale [PANSS], Scale for the Assessment of Positive Symptoms [SANS]), total scores (PANSS), and measures of general psychopathology (Hamilton Depression Scale [HAM-D], Montgomery-Asberg Depression Rating Score [MADRS]). The strength of evidence for this finding was moderate.