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Efficacy and extrapyramidal side-effects of the new antipsychotics olanzapine, quetiapine, risperidone, and sertindole compared to conventional antipsychotics and placebo. A meta-analysis of randomized controlled trials.
Schizophr Res. 1999 Jan 04; 35(1):51-68.SR

Abstract

The objective of this meta-analysis is to summarize the efficacy and tolerability of the new antipsychotics risperidone, olanzapine, sertindole and quetiapine in schizophrenia compared to placebo and conventional antipsychotics. The main results are: (1) All of the 4 new drugs are more effective than placebo, but the magnitude of the effect is only moderate [mean effect size, r, of all antipsychotics vs. placebo = 0.25, with a 95% confidence interval (CI) = 0.22-0.28, n = 2477]. (2) According to the studies published to date, sertindole and quetiapine are as effective as haloperidol, and risperidone and olanzapine are slightly more effective than haloperidol in the treatment of global schizophrenic symptomatology. (3) With respect to negative symptoms, all new antipsychotics are more effective than placebo. However, contrary to widespread opinion, so is the 'conventional' antipsychotic haloperidol. Risperidone and olanzapine are slightly superior, sertindole is as effective and--according to the only study fully published to date--quetiapine is even slightly less effective than haloperidol in this regard. (4) All new antipsychotics are associated with less frequent use of antiparkinson medication than haloperidol, with risperidone appearing to have a slightly less favourable EPS-profile than the other new antipsychotics. The methodological limitations of this review, the generalizability of the results and expectations from future research are discussed.

Authors+Show Affiliations

Psychiatrische Klinik, Technischen Universität München, Klinikum rechts der Isar, Germany. stefan.leucht@lrz.tu-muenchen.deNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis

Language

eng

PubMed ID

9988841

Citation

Leucht, S, et al. "Efficacy and Extrapyramidal Side-effects of the New Antipsychotics Olanzapine, Quetiapine, Risperidone, and Sertindole Compared to Conventional Antipsychotics and Placebo. a Meta-analysis of Randomized Controlled Trials." Schizophrenia Research, vol. 35, no. 1, 1999, pp. 51-68.
Leucht S, Pitschel-Walz G, Abraham D, et al. Efficacy and extrapyramidal side-effects of the new antipsychotics olanzapine, quetiapine, risperidone, and sertindole compared to conventional antipsychotics and placebo. A meta-analysis of randomized controlled trials. Schizophr Res. 1999;35(1):51-68.
Leucht, S., Pitschel-Walz, G., Abraham, D., & Kissling, W. (1999). Efficacy and extrapyramidal side-effects of the new antipsychotics olanzapine, quetiapine, risperidone, and sertindole compared to conventional antipsychotics and placebo. A meta-analysis of randomized controlled trials. Schizophrenia Research, 35(1), 51-68.
Leucht S, et al. Efficacy and Extrapyramidal Side-effects of the New Antipsychotics Olanzapine, Quetiapine, Risperidone, and Sertindole Compared to Conventional Antipsychotics and Placebo. a Meta-analysis of Randomized Controlled Trials. Schizophr Res. 1999 Jan 4;35(1):51-68. PubMed PMID: 9988841.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and extrapyramidal side-effects of the new antipsychotics olanzapine, quetiapine, risperidone, and sertindole compared to conventional antipsychotics and placebo. A meta-analysis of randomized controlled trials. AU - Leucht,S, AU - Pitschel-Walz,G, AU - Abraham,D, AU - Kissling,W, PY - 1999/2/16/pubmed PY - 1999/2/16/medline PY - 1999/2/16/entrez SP - 51 EP - 68 JF - Schizophrenia research JO - Schizophr Res VL - 35 IS - 1 N2 - The objective of this meta-analysis is to summarize the efficacy and tolerability of the new antipsychotics risperidone, olanzapine, sertindole and quetiapine in schizophrenia compared to placebo and conventional antipsychotics. The main results are: (1) All of the 4 new drugs are more effective than placebo, but the magnitude of the effect is only moderate [mean effect size, r, of all antipsychotics vs. placebo = 0.25, with a 95% confidence interval (CI) = 0.22-0.28, n = 2477]. (2) According to the studies published to date, sertindole and quetiapine are as effective as haloperidol, and risperidone and olanzapine are slightly more effective than haloperidol in the treatment of global schizophrenic symptomatology. (3) With respect to negative symptoms, all new antipsychotics are more effective than placebo. However, contrary to widespread opinion, so is the 'conventional' antipsychotic haloperidol. Risperidone and olanzapine are slightly superior, sertindole is as effective and--according to the only study fully published to date--quetiapine is even slightly less effective than haloperidol in this regard. (4) All new antipsychotics are associated with less frequent use of antiparkinson medication than haloperidol, with risperidone appearing to have a slightly less favourable EPS-profile than the other new antipsychotics. The methodological limitations of this review, the generalizability of the results and expectations from future research are discussed. SN - 0920-9964 UR - https://www.unboundmedicine.com/medline/citation/9988841/Efficacy_and_extrapyramidal_side_effects_of_the_new_antipsychotics_olanzapine_quetiapine_risperidone_and_sertindole_compared_to_conventional_antipsychotics_and_placebo__A_meta_analysis_of_randomized_controlled_trials_ DB - PRIME DP - Unbound Medicine ER -