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Meta-analytic study of the benefits and risks of treating chronic schizophrenia with risperidone or conventional neuroleptics

Published online by Cambridge University Press:  16 April 2020

P Bech
Affiliation:
Psychiatric Research Unit, Frederiksborg General Hospital, Hillered Sygehus, DK-3400, Hillerød, Denmark
JCJR Peuskens
Affiliation:
University Center St Jozef, Kortenberg, Belgium
SR Marder
Affiliation:
West Los Angeles VA Medical Center, Los Angeles, CA, US
G Chouinard
Affiliation:
Hôpital Louis-H Lafontaine, Montreal, Quebec, Canada
OJ Høyberg
Affiliation:
Department Of Psychiatry, Molde Hospital, Molde, Norway
MO Huttunen
Affiliation:
Department of Psychiatry, University of Helsinki, Finland
O Blin
Affiliation:
Hôapital de la Timone, Marseilles, France
A Claus
Affiliation:
University Psychiatric Hospital St Camillus, Birbeek, Belgium
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Summary

Data from six randomised, controlled, comparative studies of risperidone and conventional neuroleptics (haloperidol, zuclopenthixol and perphenazine) in the treatment of 911 patients with chronic schizophrenia were analysed to estimate the benefits and risks of treatment. Efficacy and risk of treatment were assessed by means of the Positive and Negative Syndrome Scale (PANSS) and the Extrapyramidal Symptom Rating Scale (ESRS). An effect size (difference between treatments) was calculated from the PANSS and ESRS scores. The effect size of antipsychotic effect favoured risperidone (sizes ranged from 0.22 to 0.37 on the PANSS subscales), and the effect size of safety also favoured risperidone (sizes ranged from 0.18 to 0.36 on the ESRS). An analysis of the proportions of patients requiring antiparkinsonian medication produced an effect size of 0.37 (20% of risperidone patients and 38% of patients receiving a conventional neuroleptic required antiparkinsonian medication). These data indicate that risperidone is a more effective antipsychotic than the conventional agents and causes less severe extrapyramidal symptoms.

Type
Original article
Copyright
Copyright © Elsevier, Paris 1998

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