Abstract：
:We conducted a systematic review and meta-analysis of randomized controlled trials that compared second-generation antipsychotic (SGA) drugs with placebo in schizophrenic patients and which considered 13 different outcome measures. Thirty-eight randomized controlled trials with 7323 participants were included. All SGA drugs were more effective than placebo, but the pooled effect size (ES) for overall symptoms (primary outcome) was moderate (-0.51). The absolute difference (RD) in responder rates was at 18% (41% responded to drug compared with 24% to placebo, number needed to treat=6). Similar ESs were found for the other efficacy parameters: negative symptoms (ES=-0.39), positive symptoms (ES=-0.48), depression (ES=-0.26), relapse (RD 20%) and discontinuation due to inefficacy (RD 17%). Curiously, the efficacy of haloperidol for negative and depressive symptoms was similar to that of the SGA drugs. In contrast to haloperidol, there was no difference in terms of EPS between any SGA drugs and placebo, and there was also no difference in terms of dropouts due to adverse events. Meta-regression showed a decline in treatment response over time, and a funnel plot suggested the possibility of publication bias. We conclude that the drug versus placebo difference of SGA drugs and haloperidol in recent trials was moderate, and that there is much room for more efficacious compounds. Whether methodological issues account in part for the relatively low efficacy ESs and the scarcity of adverse event differences compared with placebo needs to be established.
journal_name
Mol Psychiatryjournal_title
Molecular psychiatryauthors
Leucht S,Arbter D,Engel RR,Kissling W,Davis JMdoi
10.1038/sj.mp.4002136subject
Has Abstractpub_date
2009-04-01 00:00:00pages
429-47issue
4eissn
1359-4184issn
1476-5578pii
4002136journal_volume
14pub_type
杂志文章,meta分析,评审abstract：:Chronic stress contributes to the development of psychiatric disorders including anxiety and depression. Several inflammatory-related effects of stress are associated with increased interleukin-1 (IL-1) signaling within the central nervous system and are mediated by IL-1 receptor 1 (IL-1R1) on several distinct cell ty...
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pub_type： 杂志文章
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pub_type： 历史文章,杂志文章,评审
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journal_title：Molecular psychiatry
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journal_title：Molecular psychiatry
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更新日期：2013-09-01 00:00:00
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pub_type： 杂志文章,已发布勘误
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journal_title：Molecular psychiatry
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journal_title：Molecular psychiatry
pub_type： 杂志文章,评审
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更新日期：2010-07-01 00:00:00
