Tags

Type your tag names separated by a space and hit enter

Tolerability of atypical antipsychotics in the treatment of adults with schizophrenia or bipolar disorder: a mixed treatment comparison of randomized controlled trials.
Clin Ther. 2009 Jun; 31 Pt 1:1345-59.CT

Abstract

OBJECTIVE

This article reviews and compares the tolerability profiles of atypical antipsychotics in adults with schizophrenia or bipolar disorder in randomized controlled trials (RCTs).

METHODS

A systematic search of the BIOSIS, Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, and PsycINFO databases was conducted for English-language papers and abstracts that reported RCTs comparing > or =2 atypical antipsychotics (aripiprazole, olanzapine, quetiapine, risperidone, ziprasidone) in the treatment of adult patients with schizophrenia or bipolar disorder. The search was completed in December 2007. A panel of 4 psychiatrists with expertise in the treatment of schizophrenia, schizoaffective disorder, or bipolar disorder identified potentially relevant outcomes that would reflect patients' subjective perception of adverse effects during treatment with antipsychotic medications. These outcomes were daily activities, anxiety or depression, bodily anxiety or restlessness, dizziness or nausea, extrapyramidal symptoms (EPS), sexual dysfunction, stiffness or tremor, tiredness or weakness, and weight gain. Data on these outcomes were extracted from relevant studies, and mixed treatment comparisons were conducted using Bayesian Markov Chain Monte Carlo simulation. Summary effect estimates (odds ratios [ORs] and 95% credible intervals [95% CrIs]) were calculated and reported in comparison with risperidone.

RESULTS

The search identified 2963 potentially relevant publications, of which 50 provided data on 48 RCTs comparing > or =2 atypical antipsychotics. Outcomes that were statistically significant compared with risperi-done at the 5% level were decreased bodily anxiety or restlessness with quetiapine (OR = 0.506; 95% CrI = 0.290, 0.789), decreased EPS with quetiapine (OR = 0.441; 95% CrI = 0.129, 0.910), increased weight gain with olanzapine (OR = 2.139; 95% CrI = 1.764, 2.626), and decreased weight gain with ziprasidone (OR = 0.466; 95% CrI = 0.317, 0.657).

CONCLUSION

The atypical antipsychotics had mixed tolerability profiles in this mixed treatment comparison, with some agents having significantly greater tolerability than others depending on the outcome assessed.

Authors+Show Affiliations

AstraZeneca UK Ltd., Luton, United Kingdom. Steven.J.Edwards@astrazeneca.comNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

19698898

Citation

Edwards, Steven J., and Christopher J. Smith. "Tolerability of Atypical Antipsychotics in the Treatment of Adults With Schizophrenia or Bipolar Disorder: a Mixed Treatment Comparison of Randomized Controlled Trials." Clinical Therapeutics, vol. 31 Pt 1, 2009, pp. 1345-59.
Edwards SJ, Smith CJ. Tolerability of atypical antipsychotics in the treatment of adults with schizophrenia or bipolar disorder: a mixed treatment comparison of randomized controlled trials. Clin Ther. 2009;31 Pt 1:1345-59.
Edwards, S. J., & Smith, C. J. (2009). Tolerability of atypical antipsychotics in the treatment of adults with schizophrenia or bipolar disorder: a mixed treatment comparison of randomized controlled trials. Clinical Therapeutics, 31 Pt 1, 1345-59. https://doi.org/10.1016/j.clinthera.2009.07.004
Edwards SJ, Smith CJ. Tolerability of Atypical Antipsychotics in the Treatment of Adults With Schizophrenia or Bipolar Disorder: a Mixed Treatment Comparison of Randomized Controlled Trials. Clin Ther. 2009;31 Pt 1:1345-59. PubMed PMID: 19698898.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tolerability of atypical antipsychotics in the treatment of adults with schizophrenia or bipolar disorder: a mixed treatment comparison of randomized controlled trials. AU - Edwards,Steven J, AU - Smith,Christopher J, PY - 2009/04/08/accepted PY - 2009/8/25/entrez PY - 2009/8/25/pubmed PY - 2009/11/10/medline SP - 1345 EP - 59 JF - Clinical therapeutics JO - Clin Ther VL - 31 Pt 1 N2 - OBJECTIVE: This article reviews and compares the tolerability profiles of atypical antipsychotics in adults with schizophrenia or bipolar disorder in randomized controlled trials (RCTs). METHODS: A systematic search of the BIOSIS, Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, and PsycINFO databases was conducted for English-language papers and abstracts that reported RCTs comparing > or =2 atypical antipsychotics (aripiprazole, olanzapine, quetiapine, risperidone, ziprasidone) in the treatment of adult patients with schizophrenia or bipolar disorder. The search was completed in December 2007. A panel of 4 psychiatrists with expertise in the treatment of schizophrenia, schizoaffective disorder, or bipolar disorder identified potentially relevant outcomes that would reflect patients' subjective perception of adverse effects during treatment with antipsychotic medications. These outcomes were daily activities, anxiety or depression, bodily anxiety or restlessness, dizziness or nausea, extrapyramidal symptoms (EPS), sexual dysfunction, stiffness or tremor, tiredness or weakness, and weight gain. Data on these outcomes were extracted from relevant studies, and mixed treatment comparisons were conducted using Bayesian Markov Chain Monte Carlo simulation. Summary effect estimates (odds ratios [ORs] and 95% credible intervals [95% CrIs]) were calculated and reported in comparison with risperidone. RESULTS: The search identified 2963 potentially relevant publications, of which 50 provided data on 48 RCTs comparing > or =2 atypical antipsychotics. Outcomes that were statistically significant compared with risperi-done at the 5% level were decreased bodily anxiety or restlessness with quetiapine (OR = 0.506; 95% CrI = 0.290, 0.789), decreased EPS with quetiapine (OR = 0.441; 95% CrI = 0.129, 0.910), increased weight gain with olanzapine (OR = 2.139; 95% CrI = 1.764, 2.626), and decreased weight gain with ziprasidone (OR = 0.466; 95% CrI = 0.317, 0.657). CONCLUSION: The atypical antipsychotics had mixed tolerability profiles in this mixed treatment comparison, with some agents having significantly greater tolerability than others depending on the outcome assessed. SN - 1879-114X UR - https://www.unboundmedicine.com/medline/citation/19698898/Tolerability_of_atypical_antipsychotics_in_the_treatment_of_adults_with_schizophrenia_or_bipolar_disorder:_a_mixed_treatment_comparison_of_randomized_controlled_trials_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0149-2918(09)00203-3 DB - PRIME DP - Unbound Medicine ER -