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

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Gaps in Knowledge

Older adults, minorities, and the most seriously ill patients were under-represented in the studies, which were highly selective in patient enrollment. Thus, the studies reported here are more likely to show consistency of benefit and reduced risk of adverse effects.

The evidence about the influence of drug dose, patient age, and comorbidities is inadequate for fully informed decisionmaking.

A consensus is needed on outcomes that demonstrate patient functioning and well-being using treatment goals that are important to patients.

More head-to-head trials are needed to compare currently approved first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs) for treating bipolar disorder.

More studies are needed to evaluate long-term effectiveness and adverse effects of SGAs and FGAs.