Efficacy of atypical v. typical antipsychotics in the treatment of early psychosis: meta-analysis.
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Authors
Crossley, Nicolas A
Constante, Miguel
McGuire, Philip
Power, Paddy
Issue Date
2010-Jun
Type
Comparative Study
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Language
en
Keywords
Alternative Title
Abstract
There is an ongoing debate about the use of atypical antipsychotics as a first-line treatment for first-episode psychosis.
To examine the evidence base for this recommendation.
Meta-analyses of randomised controlled trials in the early phase of psychosis, looking at long-term discontinuation rates, short-term symptom changes, weight gain and extrapyramidal side-effects. Trials were identified using a combination of electronic (Cochrane Central, EMBASE, MEDLINE and PsycINFO) and manual searches.
Fifteen randomised controlled trials with a total of 2522 participants were included. No significant differences between atypical and typical drugs were found for discontinuation rates (odds ratio (OR) = 0.7, 95% CI 0.4 to 1.2) or effect on symptoms (standardised mean difference (SMD) = -0.1, 95% CI -0.2 to 0.02). Participants on atypical antipsychotics gained 2.1 kg (95% CI 0.1 to 4.1) more weight than those on typicals, whereas those on typicals experienced more extrapyramidal side-effects (SMD = -0.4, 95% CI -0.5 to -0.2).
There was no evidence for differences in efficacy between atypical and typical antipsychotics, but there was a clear difference in the side-effect profile.
To examine the evidence base for this recommendation.
Meta-analyses of randomised controlled trials in the early phase of psychosis, looking at long-term discontinuation rates, short-term symptom changes, weight gain and extrapyramidal side-effects. Trials were identified using a combination of electronic (Cochrane Central, EMBASE, MEDLINE and PsycINFO) and manual searches.
Fifteen randomised controlled trials with a total of 2522 participants were included. No significant differences between atypical and typical drugs were found for discontinuation rates (odds ratio (OR) = 0.7, 95% CI 0.4 to 1.2) or effect on symptoms (standardised mean difference (SMD) = -0.1, 95% CI -0.2 to 0.02). Participants on atypical antipsychotics gained 2.1 kg (95% CI 0.1 to 4.1) more weight than those on typicals, whereas those on typicals experienced more extrapyramidal side-effects (SMD = -0.4, 95% CI -0.5 to -0.2).
There was no evidence for differences in efficacy between atypical and typical antipsychotics, but there was a clear difference in the side-effect profile.
Description
Citation
Crossley, N. A., Constante, M., McGuire, P., & Power, P. (2010). Efficacy of atypical v. typical antipsychotics in the treatment of early psychosis: meta-analysis. The British journal of psychiatry : the journal of mental science, 196(6), 434–439. https://doi.org/10.1192/bjp.bp.109.066217
Publisher
License
Journal
The British journal of psychiatry : the journal of mental science
Volume
196
Issue
6
PubMed ID
ISSN
1472-1465