Olanzapine for schizophrenia.

Abstract:

BACKGROUND:Olanzapine is an atypical antipsychotic that is reported to be effective without producing the disabling extrapyramidal side effects associated with the older, typical antipsychotic drugs. OBJECTIVES:To determine the clinical effects and safety of olanzapine as compared with placebo, typical and other atypical antipsychotic drugs for schizophrenia and schizophreniform psychoses. SEARCH STRATEGY:The reviewers undertook electronic searches of Biological Abstracts (1980-1999), The Cochrane Library (Issue 2, 1999), The Cochrane Schizophrenia Group's Register (September 1999), EMBASE (1980-1999), MEDLINE (1966-1999), and PsycLIT (1974-1999). References of all identified studies were searched for further trials, and the reviewers contacted relevant pharmaceutical companies and authors of trials. SELECTION CRITERIA:All randomised clinical trials comparing olanzapine to placebo or any antipsychotic treatment for those with schizophrenia or schizophreniform psychoses. DATA COLLECTION AND ANALYSIS:Data were independently extracted. For homogeneous dichotomous data the random effects relative risk (RR), the 95% confidence intervals (CI) and, where appropriate, the number needed to treat (NNT) were calculated on an intention-to-treat basis. For continuous data the reviewers calculated weighted mean differences. MAIN RESULTS:Twenty trials are included. Attrition from olanzapine versus placebo studies was so great (olanzapine - 61%, placebo - 73% by six weeks, RR 0.85 CI 0. 7-0.98, NNT 8 CI 5-40) that interpretation of results is problematic. Olanzapine appeared superior to placebo at six weeks for the outcome of 'no important clinical response' (RR 0.88 CI 0.8-0.98, NNT 8 CI 5-27), but trial data regarding negative symptoms are equivocal for this comparison. Dizziness and dry mouth were more common in the olanzapine-treated group, and, although not statistically significant, the olanzapine group gained more weight. Data from several small trials are incomplete; but, for the short term outcome of 'no important clinical response', olanzapine seem as effective as typical antipsychotics (n=2778, RR 0.9 CI 0.76-1.06). Brief Psychiatric Rating Scale (BPRS) data tended to be equivocal but Positive and Negative Syndrome Scale (PANSS) rating of total score and negative and positive symptom sub-scores favoured olanzapine. With high attrition in both groups (olanzapine - 36%, typical drug - 49% by 6 weeks, n=2738, RR 0.85 CI 0.66-1.1; olanzapine - 83%, typical drug - 90% by 1 year, n=2738, RR 0.9 CI 0. 86-1.02), the assumptions included in all continuous data are considerable. Participants allocated olanzapine experienced fewer extrapyramidal side effects than people given haloperidol. Weight change data for the short term are not conclusive (n=2455, WMD 0.8kg CI -0.6-2.2) but the three to 12 month results suggest an average gain of four kilograms (n=233, WMD 4 CI 0.3-7.8). It is difficult to distinguish between olanzapine and other atypical drugs, although it may cause fewer extrapyramidal side effects than risperidone (n=339, RR 0.6 CI 0.4-0.9, NNH 8 CI 4-29). Olanzapine did cause more weight gain than its comparators but current data are not statistically significant (3-12 months, n=535, WMD 2.2kg CI -0.6-5). One study (n=180) found no clear differences between olanzapine and clozapine for people with treatment-resistant illness. REVIEWER'S CONCLUSIONS:For people with schizophrenia olanzapine may offer antipsychotic efficacy with fewer extrapyramidal side effects than typical drugs but more weight gain. The large proportions of participants leaving the studies early, in the large multi-centre trials makes it difficult to draw firm conclusions on clinical effects. Large, long-term randomised trials with participants, interventions and primary outcomes that are familiar to those wishing to help those with schizophrenia are long overdue.

authors

Duggan L,Fenton M,Dardennes RM,El-Dosoky A,Indran S

doi

10.1002/14651858.CD001359

keywords:

subject

Has Abstract

pub_date

2000-01-01 00:00:00

pages

CD001359

issue

2

issn

1469-493X

pii

CD001359

pub_type

杂志文章,评审
  • Intermittent pneumatic compression for treating venous leg ulcers.

    abstract:BACKGROUND:Intermittent pneumatic compression (IPC) is a mechanical method of delivering compression to swollen limbs that can be used to treat venous leg ulcers and limb swelling due to lymphoedema. OBJECTIVES:To determine whether IPC increases the healing of venous leg ulcers. To determine the effects of IPC on heal...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001899.pub4

    authors: Nelson EA,Hillman A,Thomas K

    更新日期:2014-05-12 00:00:00

  • Antibiotic prophylaxis for bacterial infections in afebrile neutropenic patients following chemotherapy.

    abstract:BACKGROUND:Bacterial infections are a major cause of morbidity and mortality in neutropenic patients following chemotherapy for malignancy. Trials have shown the efficacy of antibiotic prophylaxis in decreasing the incidence of bacterial infections, but not in reducing mortality rates. OBJECTIVES:This review aimed to ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004386.pub2

    authors: Gafter-Gvili A,Fraser A,Paul M,van de Wetering M,Kremer L,Leibovici L

    更新日期:2005-10-19 00:00:00

  • Oxycodone for cancer-related pain.

    abstract:BACKGROUND:Many people with cancer experience moderate to severe pain that requires treatment with strong opioids, such as oxycodone and morphine. Strong opioids are, however, not effective for pain in all people, neither are they well-tolerated by all people. The aim of this review was to assess whether oxycodone is a...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003870.pub6

    authors: Schmidt-Hansen M,Bennett MI,Arnold S,Bromham N,Hilgart JS

    更新日期:2017-08-22 00:00:00

  • Spinal cord stimulation for cancer-related pain in adults.

    abstract:BACKGROUND:This is an update of a review first published in The Cochrane Library in Issue 3, 2013. Cancer-related pain places a heavy burden on public health with related high expenditure. Severe pain is associated with a decreased quality of life in patients with cancer. A significant proportion of patients with cance...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD009389.pub3

    authors: Peng L,Min S,Zejun Z,Wei K,Bennett MI

    更新日期:2015-06-29 00:00:00

  • Topical umbilical cord care at birth.

    abstract:BACKGROUND:Umbilical cord infection caused many neonatal deaths before aseptic techniques were used. OBJECTIVES:The objective of this review was to assess the effects of topical cord care in preventing cord infection, illness and death. SEARCH STRATEGY:We searched the Cochrane Pregnancy and Childbirth Group trials re...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001057

    authors: Zupan J,Garner P

    更新日期:2000-01-01 00:00:00

  • Antibiotics for acute bronchitis.

    abstract:BACKGROUND:The benefits and risks of antibiotics for acute bronchitis remain unclear despite it being one of the most common illnesses seen in primary care. OBJECTIVES:To assess the effects of antibiotics in improving outcomes and assess adverse effects of antibiotic therapy for patients with a clinical diagnosis of a...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD000245.pub3

    authors: Smith SM,Fahey T,Smucny J,Becker LA

    更新日期:2014-03-01 00:00:00

  • Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus conventional surgery for great saphenous vein varices.

    abstract:BACKGROUND:Minimally invasive techniques to treat great saphenous varicose veins include ultrasound-guided foam sclerotherapy (USGFS), radiofrequency ablation (RFA) and endovenous laser therapy (EVLT). Compared with conventional surgery (high ligation and stripping (HL/S)), proposed benefits include fewer complications...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005624.pub2

    authors: Nesbitt C,Eifell RK,Coyne P,Badri H,Bhattacharya V,Stansby G

    更新日期:2011-10-05 00:00:00

  • Haloperidol versus placebo for schizophrenia.

    abstract:BACKGROUND:Haloperidol was developed in the late 1950s for use in the field of anaesthesia. Research subsequently demonstrated effects on hallucinations, delusions, aggressiveness, impulsiveness and states of excitement and led to the introduction of haloperidol as an antipsychotic. OBJECTIVES:To evaluate the clinical...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003082.pub3

    authors: Adams CE,Bergman H,Irving CB,Lawrie S

    更新日期:2013-11-15 00:00:00

  • Effectiveness of provision of animal-source foods for supporting optimal growth and development in children 6 to 59 months of age.

    abstract:BACKGROUND:Adequate nutrients early in life promote cognitive development and are critical for proper growth and functioning. The effect of individual nutrients consumed through food is often not the same as consuming the same nutrients in supplementary form due to 'food synergy', the biological and chemical interrelat...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD012818.pub2

    authors: Eaton JC,Rothpletz-Puglia P,Dreker MR,Iannotti L,Lutter C,Kaganda J,Rayco-Solon P

    更新日期:2019-02-19 00:00:00

  • Chest radiograph in acute respiratory infections in children.

    abstract:BACKGROUND:Chest radiography is widely used in children with acute lower respiratory infections, but the benefits are unknown. OBJECTIVES:To assess the effects of chest radiography for children with acute lower respiratory infections. SEARCH STRATEGY:The searches were updated in November 2004. We searched the Cochran...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001268.pub2

    authors: Swingler GH,Zwarenstein M

    更新日期:2005-07-20 00:00:00

  • Band ligation versus beta-blockers for primary prophylaxis of oesophageal variceal bleeding in children with chronic liver disease or portal vein thrombosis.

    abstract:BACKGROUND:Portal hypertension commonly accompanies advanced liver disease and often gives rise to life-threatening complications, including haemorrhage from oesophageal and gastrointestinal varices. Variceal haemorrhage commonly occurs in children with chronic liver disease or portal vein obstruction. Prevention is th...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章

    doi:10.1002/14651858.CD010546.pub2

    authors: Gana JC,Cifuentes LI,Gattini D,Villarroel Del Pino LA,Peña A,Torres-Robles R

    更新日期:2019-09-24 00:00:00

  • Combined spinal-epidural versus spinal anaesthesia for caesarean section.

    abstract:BACKGROUND:Single-shot spinal anaesthesia (SSS) and combined spinal-epidural (CSE) anaesthesia are both commonly used for caesarean section anaesthesia. Spinals offer technical simplicity and rapid onset of nerve blockade which can be associated with hypotension. CSE anaesthesia allows for more gradual onset and also p...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD008100.pub2

    authors: Simmons SW,Dennis AT,Cyna AM,Richardson MG,Bright MR

    更新日期:2019-10-11 00:00:00

  • Head midline position for preventing the occurrence or extension of germinal matrix-intraventricular hemorrhage in preterm infants.

    abstract:BACKGROUND:Preterm birth is known to constitute the major risk factor for development of germinal matrix-intraventricular hemorrhage (GM-IVH). Head position may affect cerebral hemodynamics and thus may be involved indirectly in development of GM-IVH. Turning the head toward one side may functionally occlude jugular ve...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD012362.pub2

    authors: Romantsik O,Calevo MG,Bruschettini M

    更新日期:2017-07-20 00:00:00

  • Booster dose vaccination for preventing hepatitis B.

    abstract:BACKGROUND:Antibodies against hepatitis B surface antigen (HBsAg) wane over time following hepatitis B immunisation; hence, it is unclear whether people vaccinated in three-dose or four-dose schedules of the hepatitis B vaccine are still immune when the hepatitis B surface antibody (anti-HBs) level in their body is und...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD008256.pub3

    authors: Poorolajal J,Hooshmand E

    更新日期:2016-06-07 00:00:00

  • Rifamycins (rifampicin, rifabutin and rifapentine) compared to isoniazid for preventing tuberculosis in HIV-negative people at risk of active TB.

    abstract:BACKGROUND:Preventing active tuberculosis (TB) from developing in people with latent tuberculosis infection (LTBI) is important for global TB control. Isoniazid (INH) for six to nine months has 60% to 90% protective efficacy, but the treatment period is long, liver toxicity is a problem, and completion rates outside tr...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD007545.pub2

    authors: Sharma SK,Sharma A,Kadhiravan T,Tharyan P

    更新日期:2013-07-05 00:00:00

  • Prophylactic versus therapeutic amnioinfusion for oligohydramnios in labour.

    abstract:BACKGROUND:Amnioinfusion aims to relieve umbilical cord compression during labour by infusing a liquid into the uterine cavity. OBJECTIVES:The objective of this review was to assess the effects of prophylactic amnioinfusion for oligohydramnios compared with therapeutic amnioinfusion only if fetal heart rate decelerati...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000176

    authors: Hofmeyr GJ

    更新日期:2000-01-01 00:00:00

  • Routine anticonvulsants for treating cerebral malaria.

    abstract:BACKGROUND:Cerebral malaria is a common complication of Plasmodium falciparum infection, and kills over a million people every year. People with cerebral malaria become unconscious, and often have protracted convulsions. It is unclear whether giving anticonvulsant drugs routinely to people with cerebral malaria will im...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002152

    authors: Meremikwu M,Marson AG

    更新日期:2002-01-01 00:00:00

  • Fish oil for kidney transplant recipients.

    abstract:BACKGROUND:Calcineurin inhibitors used in kidney transplantation for immunosuppression have adverse effects that may contribute to nephrotoxicity and increased cardiovascular risk profile. Fish oils are rich in very long chain omega-3 fatty acids, which may reduce nephrotoxicity by improving endothelial function and re...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005282.pub2

    authors: Lim AK,Manley KJ,Roberts MA,Fraenkel MB

    更新日期:2007-04-18 00:00:00

  • Antibiotics versus placebo for acute bacterial conjunctivitis.

    abstract:BACKGROUND:There are concerns about whether antibiotic therapy confers significant clinical benefit in the treatment of acute bacterial conjunctivitis. OBJECTIVES:The aim of this review was to assess the benefit and harm of antibiotic therapy in the management of acute bacterial conjunctivitis. SEARCH STRATEGY:We sea...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001211.pub2

    authors: Sheikh A,Hurwitz B

    更新日期:2006-04-19 00:00:00

  • Cholinesterase inhibitors for rarer dementias associated with neurological conditions.

    abstract:BACKGROUND:Rarer dementias include Huntington's disease (HD), cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), frontotemporal dementia (FTD), dementia in multiple sclerosis (MS) and progressive supranuclear palsy (PSP). Cholinesterase inhibitors, including donepezil,...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD009444.pub3

    authors: Li Y,Hai S,Zhou Y,Dong BR

    更新日期:2015-03-03 00:00:00

  • Indoor residual spraying for preventing malaria.

    abstract:BACKGROUND:Primary malaria prevention on a large scale depends on two vector control interventions: indoor residual spraying (IRS) and insecticide-treated mosquito nets (ITNs). Historically, IRS has reduced malaria transmission in many settings in the world, but the health effects of IRS have never been properly quanti...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD006657.pub2

    authors: Pluess B,Tanser FC,Lengeler C,Sharp BL

    更新日期:2010-04-14 00:00:00

  • Rivastigmine for vascular cognitive impairment.

    abstract:BACKGROUND:Vascular dementia represents the second most common type of dementia. The classification of vascular dementia broadly follows three clinico-pathological processes: multi-infarct dementia, single strategic infarct dementia and subcortical dementia. As not all victims fulfil strict criteria for dementia and ma...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004744.pub2

    authors: Craig D,Birks J

    更新日期:2005-04-18 00:00:00

  • Ocriplasmin for symptomatic vitreomacular adhesion.

    abstract:BACKGROUND:Symptomatic vitreomacular adhesion (sVMA) is a recognised cause of visual loss and by tradition has been managed by pars plana vitrectomy (PPV). A less invasive alternative to surgery in some people is enzymatic vitreolysis, using an intravitreal injection of ocriplasmin. OBJECTIVES:To assess the efficacy a...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD011874.pub2

    authors: Neffendorf JE,Kirthi V,Pringle E,Jackson TL

    更新日期:2017-10-17 00:00:00

  • Fresh versus frozen embryo transfers in assisted reproduction.

    abstract:BACKGROUND:In general, in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) implies a single fresh and one or more frozen-thawed embryo transfers. Alternatively, the 'freeze-all' strategy implies transfer of frozen-thawed embryos only, with no fresh embryo transfers. In practice, both strategies can ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD011184.pub2

    authors: Wong KM,van Wely M,Mol F,Repping S,Mastenbroek S

    更新日期:2017-03-28 00:00:00

  • Face-to-face interventions for informing or educating parents about early childhood vaccination.

    abstract:BACKGROUND:Early childhood vaccination is an essential global public health practice that saves two to three million lives each year, but many children do not receive all the recommended vaccines. To achieve and maintain appropriate coverage rates, vaccination programmes rely on people having sufficient awareness and a...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD010038.pub3

    authors: Kaufman J,Ryan R,Walsh L,Horey D,Leask J,Robinson P,Hill S

    更新日期:2018-05-08 00:00:00

  • Platinum-containing regimens for triple-negative metastatic breast cancer.

    abstract:BACKGROUND:In a previous Cochrane Review, we found that for women with metastatic breast cancer unselected for triple-negative disease, there is little or no survival benefit and excess toxicity from platinum-based regimens. In subgroup analyses, however, we found preliminary low-quality evidence of a survival benefit ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD013750

    authors: Egger SJ,Chan MMK,Luo Q,Wilcken N

    更新日期:2020-10-21 00:00:00

  • WITHDRAWN: Caesarean delivery for the second twin.

    abstract:BACKGROUND:The optimal mode of birth for a second twin in breech position is controversial, with support for both caesarean and vaginal birth. OBJECTIVES:The objective of this review was to assess the effects of caesarean birth compared with vaginal birth of a second twin not presenting cephalically. SEARCH METHODS:T...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000047.pub2

    authors: Crowther CA

    更新日期:2011-12-07 00:00:00

  • Corticosteroid therapy for nephrotic syndrome in children.

    abstract:BACKGROUND:In nephrotic syndrome protein leaks from the blood to the urine through the glomeruli resulting in hypoproteinaemia and generalised oedema. Children with untreated nephrotic syndrome frequently die from infections. The majority of children with nephrotic syndrome respond to corticosteroids. However about 70%...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001533

    authors: Hodson EM,Knight JF,Willis NS,Craig JC

    更新日期:2003-01-01 00:00:00

  • Liposomal bupivacaine peripheral nerve block for the management of postoperative pain.

    abstract:BACKGROUND:Postoperative pain remains a significant issue with poor perioperative pain management associated with an increased risk of morbidity and mortality. Liposomal bupivacaine is an analgesic consisting of bupivacaine hydrochloride encapsulated within multiple, non-concentric lipid bi-layers offering a novel meth...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD011476.pub2

    authors: Hamilton TW,Athanassoglou V,Trivella M,Strickland LH,Mellon S,Murray D,Pandit HG

    更新日期:2016-08-25 00:00:00

  • Early enteral nutrition within 24 hours of lower gastrointestinal surgery versus later commencement for length of hospital stay and postoperative complications.

    abstract:BACKGROUND:This is an update of the review last published in 2011. It focuses on early postoperative enteral nutrition after lower gastrointestinal surgery. Traditional management consisted of 'nil by mouth', where patients receive fluids followed by solids after bowel function has returned. Although several trials hav...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD004080.pub3

    authors: Herbert G,Perry R,Andersen HK,Atkinson C,Penfold C,Lewis SJ,Ness AR,Thomas S

    更新日期:2018-10-24 00:00:00