Abstract:
OBJECTIVE:To develop an evidence base for recommendations on the use of atypical antipsychotics for patients with schizophrenia. DESIGN:Systematic overview and meta-regression analyses of randomised controlled trials, as a basis for formal development of guidelines. SUBJECTS:12 649 patients in 52 randomised trials comparing atypical antipsychotics (amisulpride, clozapine, olanzapine, quetiapine, risperidone, and sertindole) with conventional antipsychotics (usually haloperidol or chlorpromazine) or alternative atypical antipsychotics. MAIN OUTCOME MEASURES:Overall symptom scores. Rate of drop out (as a proxy for tolerability) and of side effects, notably extrapyramidal side effects. RESULTS:For both symptom reduction and drop out, there was substantial heterogeneity between the results of trials, including those evaluating the same atypical antipsychotic and comparator drugs. Meta-regression suggested that dose of conventional antipsychotic explained the heterogeneity. When the dose was =12 mg/day of haloperidol (or equivalent), atypical antipsychotics had no benefits in terms of efficacy or overall tolerability, but they still caused fewer extrapyramidal side effects. CONCLUSIONS:There is no clear evidence that atypical antipsychotics are more effective or are better tolerated than conventional antipsychotics. Conventional antipsychotics should usually be used in the initial treatment of an episode of schizophrenia unless the patient has previously not responded to these drugs or has unacceptable extrapyramidal side effects.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Geddes J,Freemantle N,Harrison P,Bebbington Pdoi
10.1136/bmj.321.7273.1371keywords:
subject
Has Abstractpub_date
2000-12-02 00:00:00pages
1371-6issue
7273eissn
0959-8138issn
1756-1833journal_volume
321pub_type
杂志文章,meta分析,评审abstract:OBJECTIVE: To determine whether the treatment effect of apixaban versus warfarin differs with increasing numbers of concomitant drugs used by patients with atrial fibrillation. DESIGN: Post hoc analysis performed in 2015 of results from ARISTOTLE (apixaban for reduction in stroke and other thromboembolic events in atr...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.i2868
更新日期:2016-06-15 00:00:00
abstract:OBJECTIVE:To compare the effectiveness of corticosteroid injections with physiotherapy for the treatment of painful stiff shoulder. DESIGN:Randomised trial. SETTING:40 general practices. SUBJECTS:109 patients consulting general practitioners for shoulder pain were enrolled in the trial. INTERVENTIONS:Patients were ...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.317.7168.1292
更新日期:1998-11-07 00:00:00
abstract:OBJECTIVES:To estimate life expectancy for people with HIV undergoing treatment compared with life expectancy in the general population and to assess the impact on life expectancy of late treatment, defined as CD4 count <200 cells/mm(3) at start of antiretroviral therapy. DESIGN:Cohort study. SETTING:Outpatient HIV c...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.d6016
更新日期:2011-10-11 00:00:00
abstract::In a one year prospective study within the Trent Regional Health Authority the demand for neonatal intensive care was estimated to be 1.1 cots per 1000 births. Intensive care level 1 (as defined by the British Paediatric Association and British Association for Perinatal Paediatrics) was determined by two separate tech...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6711.1305
更新日期:1989-11-25 00:00:00
abstract:OBJECTIVE:To map and assess prognostic models for outcome prediction in patients with chronic obstructive pulmonary disease (COPD). DESIGN:Systematic review. DATA SOURCES:PubMed until November 2018 and hand searched references from eligible articles. ELIGIBILITY CRITERIA FOR STUDY SELECTION:Studies developing, valid...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.l5358
更新日期:2019-10-04 00:00:00
abstract:OBJECTIVE:To assess the implementation of action protocols dictated by antenatal risk factors noted at the initial (booking) antenatal visit. DESIGN:Retrospective study of 2000 women delivered between 1 March 1990 and 29 March 1991. SETTING:Maternity department of a district general hospital supporting a multiethnic ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.305.6863.1184
更新日期:1992-11-14 00:00:00
abstract:UNLABELLED:OBJECTIVE--To measure needs for care of patients aged 18-65 years with major mental illness. DESIGN:Identification of everyone in one area seen by a health professional within the previous five years because of a psychotic disorder. Interview of a one in three sample of patients and their main carers with t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7046.1582
更新日期:1996-06-22 00:00:00
abstract:OBJECTIVE:To determine how changes in the number of admissions from waiting lists and changes in the number of additions to the lists are related to list size and waiting times, in the context of local waiting list initiatives. DESIGN:Review of national and Körner statistics. SETTING:England (1987-94) and districts o...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.7008.783
更新日期:1995-09-23 00:00:00
abstract::Lifetime fertility, abortion rates, and the proportion of pregnancies resulting in induced abortion were investigated in 105 district health authorities in England. In 1995, a total of 147,851 abortions occurred among women living in England, compared with 613,257 live births; a ratio of 1:4. This was equivalent to ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.316.7146.1711
更新日期:1998-06-06 00:00:00
abstract::According to a London physician, women with epilepsy taking antiepileptic drugs can take combined oral contraceptives (OCs). It is usual to recommend a combined OC preparation containing at least 50 mcg of estrogen (Ovran) from patients taking enzyme-inducing antiepileptic drugs; this can be increased to 60 mcg by ta...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.307.6902.492
更新日期:1993-08-21 00:00:00
abstract:OBJECTIVE:To determine whether prophylactic treatment with low molecular weight heparin reduces the incidence of thrombosis in patients who have had general or orthopaedic surgery. DESIGN:Meta-analysis of results from 52 randomised, controlled clinical studies (29 in general surgery and 23 in orthopaedic surgery) in w...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,meta分析,随机对照试验
doi:10.1136/bmj.305.6859.913
更新日期:1992-10-17 00:00:00
abstract:OBJECTIVE:To establish whether there is evidence of the efficacy of homoeopathy from controlled trials in humans. DESIGN:Criteria based meta-analysis. Assessment of the methodological quality of 107 controlled trials in 96 published reports found after an extensive search. Trials were scored using a list of predefined...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.302.6772.316
更新日期:1991-02-09 00:00:00
abstract::The World Health Organization's (WHO) definition of health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity" had the merit of widening concepts of health to include psychological and social aspects, but is of no practical use. In fact, this statement m...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7091.1409
更新日期:1997-05-10 00:00:00
abstract:OBJECTIVE:To investigate the effect of immediate feedback from a point of care test for salivary nicotine metabolites in promoting smoking cessation and reduction in tobacco use. DESIGN:Prospective, operator blinded, randomised controlled trial. SETTING:General dental practice, London. PARTICIPANTS:100 adult smokers...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.38621.463900.7C
更新日期:2005-10-29 00:00:00
abstract:OBJECTIVE:To determine whether maternal smoking during pregnancy causes impairment in growth after birth. DESIGN:Longitudinal study. SETTING:Six medical university centres of six towns of north, central, and south Italy. SUBJECTS:12,987 babies (10,238 born from non-smoking mothers, 2276 from mothers smoking one to n...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6982.768
更新日期:1995-03-25 00:00:00
abstract:OBJECTIVE:To assess the effectiveness of health checks by nurses in reducing risk factors for cardiovascular disease in patients from general practice. DESIGN:Randomised controlled trial. SETTING:Five urban general practices in Bedfordshire. SUBJECTS:2136 patients receiving an initial health check in 1989-91 and sch...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-01-29 00:00:00
abstract:OBJECTIVE:To evaluate the effects on suicidal behaviour of legislation limiting the size of packs of paracetamol and salicylates sold over the counter. DESIGN:Before and after study. SETTING:UK population, with detailed monitoring of data from five liver units and seven general hospitals, between September 1996 and S...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.322.7296.1203
更新日期:2001-05-19 00:00:00
abstract:OBJECTIVE:To use the rs1229984 variant in the alcohol dehydrogenase 1B gene (ADH1B) as an instrument to investigate the causal role of alcohol in cardiovascular disease. DESIGN:Mendelian randomisation meta-analysis of 56 epidemiological studies. PARTICIPANTS:261 991 individuals of European descent, including 20 259 c...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.g4164
更新日期:2014-07-10 00:00:00
abstract:OBJECTIVE:To quantify the impact of citalopram and other selective serotonin reuptake inhibitors on corrected QT interval (QTc), a marker of risk for ventricular arrhythmia, in a large and diverse clinical population. DESIGN:A cross sectional study using electrocardiographic, prescribing, and clinical data from electr...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f288
更新日期:2013-01-29 00:00:00
abstract:OBJECTIVES:To determine the prevalence of drug and alcohol use among newly remanded prisoners, assess the effectiveness of prison reception screening, and examine the clinical management of substance misusers among remand prisoners. DESIGN:A consecutive case study of remand prisoners screened at reception for substanc...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.315.7099.18
更新日期:1997-07-05 00:00:00
abstract:OBJECTIVES:To compare the effectiveness of in vitro fertilisation with single embryo transfer or in vitro fertilisation in a modified natural cycle with that of intrauterine insemination with controlled ovarian hyperstimulation in terms of a healthy child. DESIGN:Multicentre, open label, three arm, parallel group, ran...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.g7771
更新日期:2015-01-09 00:00:00
abstract::For the past 18 years there has been a proliferation of European committees, boards, associations, colleges, and working groups set up to promote the harmonisation of specialist training in Europe. It has been taken as read that this objective is desirable. The fact that these bodies have achieved remarkably little is...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.7000.297
更新日期:1995-07-29 00:00:00
abstract:OBJECTIVE:To investigate the risk of glioma in adults in relation to mobile phone use. DESIGN:Population based case-control study with collection of personal interview data. SETTING:Five areas of the United Kingdom. PARTICIPANTS:966 people aged 18 to 69 years diagnosed with a glioma from 1 December 2000 to 29 Februa...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.38720.687975.55
更新日期:2006-04-15 00:00:00
abstract:OBJECTIVE:To obtain information about the computerisation of general practice in Wales, and to enable more effective planning of educational provision for doctors and other primary health care workers. DESIGN:Postal questionnaire sent to all general practices in Wales. SUBJECTS:553 general practices, of which 401 (73...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.303.6794.93
更新日期:1991-07-13 00:00:00
abstract:OBJECTIVE:To quantify the association of indices of central obesity, including waist circumference, hip circumference, thigh circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, and A body shape index, with the risk of all cause mortality in the general population, and t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.m3324
更新日期:2020-09-23 00:00:00
abstract:OBJECTIVE:To determine whether low dose aspirin protects women aged 65 or more against cognitive decline. DESIGN:Cohort study within both arms of the women's health study, a randomised, double blind, placebo controlled trial of low dose aspirin for the primary prevention of cardiovascular disease and cancer, 1992-5. ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.39166.597836.BE
更新日期:2007-05-12 00:00:00
abstract::For an unprepared sexually active teenager the 1990s present a minefield of potential problems in addition to the most obvious problems of unplanned pregnancy and sexually transmitted disease. Promoting the importance of a healthy sexual and reproductive life to young people requires openness, better sex education, re...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.309.6957.786
更新日期:1994-09-24 00:00:00
abstract:OBJECTIVES:To assess the associations between both uric acid levels and hyperuricaemia, with ischaemic heart disease and blood pressure, and to explore the potentially confounding role of body mass index. DESIGN:Mendelian randomisation analysis, using variation at specific genes (SLC2A9 (rs7442295) as an instrument fo...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f4262
更新日期:2013-07-18 00:00:00
abstract:OBJECTIVE:To analyse the cost effectiveness of a national programme to screen blood donors for infection with the human T cell leukaemia/lymphoma virus. DESIGN:Three models for calculating the costs and benefits of screening were developed. The first model analysed the cost of continuously testing all donations; the s...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.316.7142.1417
更新日期:1998-05-09 00:00:00
abstract:OBJECTIVES:To evaluate integrated care for diabetes in clinical, psychosocial, and economic terms. DESIGN:Pragmatic randomised trial. SETTING:Hospital diabetic clinic and three general practice groups in Grampian. PATIENTS:274 adult diabetic patients attending a hospital clinic and registered with one of three gener...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-05-07 00:00:00