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Risperidone versus typical antipsychotic medication for schizophrenia.
R H Hunter1, C B Joy, E Kennedy
1Research and Development, Greater Glasgow Primary Care NHS Trust, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, Scotland, UK, G12 0XH. robert.hunter@gartnavel.glacomen.scot.nhs.uk
The Cochrane Database of Systematic Reviews
|June 14, 2003
Summary
Risperidone, a newer antipsychotic, shows improved clinical outcomes and fewer movement disorders compared to older drugs for schizophrenia. However, it may cause weight gain and rhinitis, necessitating a balance of benefits against costs.
Area of Science:
- Psychiatry and Pharmacology
- Clinical Trial Analysis
- Evidence-Based Medicine
Background:
- Introduction of risperidone as a 'new generation' antipsychotic.
- Potential for reduced movement disorders and improved negative symptoms compared to older antipsychotics like chlorpromazine and haloperidol.
Purpose of the Study:
- To evaluate the efficacy and tolerability of risperidone for schizophrenia.
- Comparison of risperidone against conventional neuroleptic drugs.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Updated literature searches in 2002 across multiple databases (e.g., MEDLINE, EMBASE, PsycLIT).
- Inclusion of RCTs comparing risperidone with conventional neuroleptics for schizophrenia.
Main Results:
- Risperidone demonstrated improved clinical outcomes (PANSS scores) and reduced relapse rates compared to haloperidol in short- and long-term studies.
- Significantly fewer general movement disorders and reduced use of antiparkinsonian drugs with risperidone.
- Increased weight gain and rhinitis were observed with risperidone; sexual dysfunction rates were comparable to haloperidol.
Conclusions:
- Risperidone may offer improved acceptability and marginal clinical benefits over older antipsychotics, with a potentially better adverse effect profile than haloperidol.
- The benefits of risperidone must be weighed against its higher cost and increased risk of weight gain.
- Further independent replication of long-term data on relapse reduction is warranted.