Evidence map›Paper›PMID 17015810›Full record

Trial reportArchives of general psychiatry2006

Randomized controlled trial of the effect on Quality of Life of second- vs first-generation antipsychotic drugs in schizophrenia: Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS 1).

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

Abstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Archives of general psychiatry, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 309 papers, 30 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
309citing papers in PubMed, 30 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

309 citing papers in PubMed, 30 syntheses or guidelines pooled it.

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  4. Treatment Recommendations for Tardive Dyskinesia.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2019
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  7. Bifeprunox versus placebo for schizophrenia.The Cochrane database of systematic reviews · 2016
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  9. Fluphenazine (oral) versus atypical antipsychotics for schizophrenia.The Cochrane database of systematic reviews · 2016
    Pooled it
  10. Practical clinical trials in psychopharmacology: a systematic review.Journal of clinical psychopharmacology · 2015
    Pooled it
  11. Fluphenazine decanoate (depot) and enanthate for schizophrenia.The Cochrane database of systematic reviews · 2015
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  18. Aripiprazole versus other atypical antipsychotics for schizophrenia.The Cochrane database of systematic reviews · 2014
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  19. Quetiapine versus other atypical antipsychotics for schizophrenia.The Cochrane database of systematic reviews · 2013
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  20. Pooled it

249 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.

Peter B JonesDepartment of Psychiatry, University of Cambridge and Cambridgeshire and Peterborough Mental Health NHS Trust, Cambridge, England. pbj21@cam.ac.uk
Thomas R E Barnes
Linda Davies
Graham Dunn
Helen Lloyd
Karen P Hayhurst
Robin M Murray
Alison Markwick
Shôn W Lewis

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

contextSecond-generation (atypical) antipsychotics (SGAs) are more expensive than first-generation (typical) antipsychotics (FGAs) but are perceived to be more effective, with fewer adverse effects, and preferable to patients. Most evidence comes from short-term efficacy trials of symptoms.

objectiveTo test the hypothesis that in people with schizophrenia requiring a change in treatment, SGAs other than clozapine are associated with improved quality of life across 1 year compared with FGAs.

designA noncommercially funded, pragmatic, multisite, randomized controlled trial of antipsychotic drug classes, with blind assessments at 12, 26, and 56 weeks using intention-to-treat analysis.

settingFourteen community psychiatric services in the English National Health Service.

participantsTwo hundred twenty-seven people aged 18 to 65 years with DSM-IV schizophrenia and related disorders assessed for medication review because of inadequate response or adverse effects.

interventionsRandomized prescription of either FGAs or SGAs (other than clozapine), with the choice of individual drug made by the managing psychiatrist.

main outcome measuresQuality of Life Scale scores, symptoms, adverse effects, participant satisfaction, and costs of care.

resultsThe primary hypothesis of significant improvement in Quality of Life Scale scores during the year after commencement of SGAs vs FGAs was excluded. Participants in the FGA arm showed a trend toward greater improvements in Quality of Life Scale and symptom scores. Participants reported no clear preference for either drug group; costs were similar.

conclusionsIn people with schizophrenia whose medication is changed for clinical reasons, there is no disadvantage across 1 year in terms of quality of life, symptoms, or associated costs of care in using FGAs rather than nonclozapine SGAs. Neither inadequate power nor patterns of drug discontinuation accounted for the result.

Indexed as

Quality of LifeAdolescentAdultAntipsychotic AgentsCost-Benefit AnalysisEnglandFemaleFollow-Up StudiesHealth Care CostsHumansMaleMiddle AgedPatient SatisfactionPractice Patterns, Physicians'Psychiatric Status Rating ScalesSchizophreniaAntipsychotic Agents

Identifiers

PMID17015810

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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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.