SynthesisBMJ (Clinical research ed.)2000
Atypical antipsychotics in the treatment of schizophrenia: systematic overview and meta-regression analysis.
Synthesis in BMJ (Clinical research ed.), 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 210 papers, 20 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
210 citing papers in PubMed, 20 syntheses or guidelines pooled it, 1,065 citations in OpenAlex.
- Evaluation of normal tissue complications in breast cancer re-irradiation: a meta-analysis study.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Pooled it
- Pooled it
- Chlorpromazine dose for people with schizophrenia.The Cochrane database of systematic reviews · 2017Pooled it
- Risperidone (depot) for schizophrenia.The Cochrane database of systematic reviews · 2016Pooled it
- Pooled it
- Aripiprazole alone or in combination for acute mania.The Cochrane database of systematic reviews · 2013Pooled it
- The estimation of utility weights in cost-utility analysis for mental disorders: a systematic review.PharmacoEconomics · 2013Pooled it
- Quetiapine versus typical antipsychotic medications for schizophrenia.The Cochrane database of systematic reviews · 2013Pooled it
- Levomepromazine for schizophrenia.The Cochrane database of systematic reviews · 2010Pooled it
- Efficacy of atypical v. typical antipsychotics in the treatment of early psychosis: meta-analysis.The British journal of psychiatry : the journal of mental science · 2010Pooled it
- Dropout rates in randomized clinical trials of antipsychotics: a meta-analysis comparing first- and second-generation drugs and an examination of the role of trial design features.Schizophrenia bulletin · 2009Pooled it
- How effective are second-generation antipsychotic drugs? A meta-analysis of placebo-controlled trials.Molecular psychiatry · 2009Pooled it
- A systematic review of the Soteria paradigm for the treatment of people diagnosed with schizophrenia.Schizophrenia bulletin · 2008Pooled it
- Duloxetine compared with fluoxetine and venlafaxine: use of meta-regression analysis for indirect comparisons.BMC psychiatry · 2006Pooled it
- Haloperidol alone or in combination for acute mania.The Cochrane database of systematic reviews · 2006Pooled it
- Antipsychotics in early onset Schizophrenia: Systematic review and meta-analysis.European child & adolescent psychiatry · 2006Pooled it
- Head-to-head comparison of the costs of atypical antipsychotics: a systematic review.CNS drugs · 2005Pooled it
- Efficacy of olanzapine and ziprasidone for the treatment of schizophrenia: a systematic review.CNS drugs · 2005Pooled it
- Trifluoperazine for schizophrenia.The Cochrane database of systematic reviews · 2004Pooled it
- Pooled it
150 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo develop an evidence base for recommendations on the use of atypical antipsychotics for patients with schizophrenia.
designSystematic 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 measuresOverall symptom scores. Rate of drop out (as a proxy for tolerability) and of side effects, notably extrapyramidal side effects.
resultsFor 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.
conclusionsThere 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.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.