Evidence map›Paper›PMID 16540702›Full record

Trial reportSchizophrenia bulletin2006

Randomized controlled trial of effect of prescription of clozapine versus other second-generation antipsychotic drugs in resistant schizophrenia.

Shôn W Lewis, Thomas R E Barnes, Linda Davies, Robin M Murray, Graham Dunn, Karen P Hayhurst, Alison Markwick, Helen Lloyd, Peter B Jones

Registry-linked trialOpen access · bronzeAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Schizophrenia bulletin, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02640300 (Switching Antipsychotics), which is not on this map. Cited by 129 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
129citing papers in PubMed, 10 pooled it
7.7field-weighted citation impact, top 2% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT02640300 phase4completednot on this map

Switching Antipsychotics: Abrupt Discontinuation Versus Overlap

TypeinterventionalSponsorCentre for Addiction and Mental HealthRan1999 to 2004Enrolled33ConditionsSchizophrenia, Schizoaffective DisorderArmsClozapine
3 · Its place in the literature

Who cites it

129 citing papers in PubMed, 10 syntheses or guidelines pooled it, 418 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Antipsychotic medication for early episode schizophrenia.The Cochrane database of systematic reviews · 2011
    Pooled it
  7. Clozapine versus other atypical antipsychotics for schizophrenia.The Cochrane database of systematic reviews · 2010
    Pooled it
  8. Guideline
  9. Pooled it
  10. Clozapine versus typical neuroleptic medication for schizophrenia.The Cochrane database of systematic reviews · 2009
    Pooled it
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Adjunctive risperidone for partially responsive people with schizophrenia treated with clozapine.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2010
    Trial
  16. Trial
  17. Trial
  18. Clozapine-induced Myocarditis in Korea: Analysis of a Nationwide Database and Comparison to Other Countries.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2026
    Article
  19. Review
  20. Article

69 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Shôn W LewisUniversity of Manchester, London. shon.lewis@manchester.ac.uk
Thomas R E Barnes
Linda Davies
Robin M Murray
Graham Dunn
Karen P Hayhurst
Alison Markwick
Helen Lloyd
Peter B Jones
University of Manchester · GBImperial College London · GBUniversity of Cambridge · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

There is good evidence that clozapine is more efficacious than first-generation antipsychotic drugs in resistant schizophrenia. It is less clear if clozapine is more effective than the other second-generation antipsychotic (SGA) drugs. A noncommercially funded, pragmatic, open, multisite, randomized controlled trial was conducted in the United Kingdom National Health Service (NHS). Participants were 136 people aged 18-65 with DSM-IV schizophrenia and related disorders whose medication was being changed because of poor clinical response to 2 or more previous antipsychotic drugs. Participants were randomly allocated to clozapine or to one of the class of other SGA drugs (risperidone, olanzapine, quetiapine, amisulpride) as selected by the managing clinician. Outcomes were assessed blind to treatment allocation. One-year assessments were carried out in 87% of the sample. The intent to treat comparison showed no statistically significant advantage for commencing clozapine in Quality of Life score (3.63 points; CI: 0.46-7.71; p = .08) but did show an advantage in Positive and Negative Syndrome Scale (PANSS) total score that was statistically significant (-4.93 points; CI: -8.82 to -1.05; p = .013) during follow-up. Clozapine showed a trend toward having fewer total extrapyramidal side effects. At 12 weeks participants who were receiving clozapine reported that their mental health was significantly better compared with those receiving other SGA drugs. In conclusion, in people with schizophrenia with poor treatment response to 2 or more antipsychotic drugs, there is an advantage to commencing clozapine rather than other SGA drugs in terms of symptom improvement over 1 year.

Indexed as

AdolescentAdultAntipsychotic AgentsClozapineDepressive DisorderDrug ResistanceFemaleFollow-Up StudiesHumansMaleMiddle AgedPsychiatric Status Rating ScalesQuality of LifeSchizophreniaSchizophrenic PsychologyAntipsychotic AgentsClozapine

Identifiers

PMID16540702
PMCPMC2632262
OpenAlexW2127772714

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.