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Comparative effectiveness of second-generation antipsychotics and haloperidol in acute schizophrenia
Robert E McCue1, Rubina Waheed, Leonel Urcuyo
1Department of Psychiatry, Wooodhull Medical and Mental Health Center, 760 Broadway, Brooklyn, New York 11206, USA. mccuer@nychhc.org
Background:
There is little information on the comparative effectiveness of second-generation antipsychotic agents.
Aims:
To determine if any of five second-generation antipsychotics or haloperidol is more effective in treating acutely ill patients with schizophrenia, schizoaffective disorder or schizophreniform disorder.
Method:
A sample of 327 newly admitted patients were randomised to open-label treatment with aripiprazole, haloperidol, olanzapine, quetiapine, risperidone or ziprasidone for a minimum of 3 weeks. Measures of effectiveness were improvement in mental status so that the patient no longer required acute in-patient care, and changes in Brief Psychiatric Rating Scale (BPRS) scores.
Results:
By the first measure, haloperidol (89%), olanzapine (92%) and risperidone (88%) were significantly more effective than aripiprazole (64%), quetiapine (64%) and ziprasidone (64%). Changes in BPRS ratings were not significant among treatments.
Conclusions:
Haloperidol, olanzapine and risperidone are superior to aripiprazole, quetiapine and ziprasidone for the acute treatment of psychosis in hospitalised patients with schizophrenia, schizoaffective disorder or schizophreniform disorder.
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