SynthesisThe international journal of neuropsychopharmacology2013
Efficacy and safety of individual second-generation vs. first-generation antipsychotics in first-episode psychosis: a systematic review and meta-analysis.
Synthesis in The international journal of neuropsychopharmacology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 124 papers, 12 of them syntheses that pooled it.
What it found
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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
124 citing papers in PubMed, 12 syntheses or guidelines pooled it.
- Integrating genome-wide and epigenome-wide associations for antipsychotic induced extrapyramidal side effects.Psychopharmacology · 2026Pooled it
- Non-pharmacological interventions for antipsychotic drug-related metabolic abnormalities: a systematic narrative review.BMC psychiatry · 2026Pooled it
- COVID-19 risk, course and outcome in people with mental disorders: a systematic review and meta-analyses.Epidemiology and psychiatric sciences · 2023Pooled it
- Peripheral Blood-Based Gene Expression Studies in Schizophrenia: A Systematic Review.Frontiers in genetics · 2021Pooled it
- Pharmacological Augmentation in Unipolar Depression: A Guide to the Guidelines.The international journal of neuropsychopharmacology · 2020Pooled it
- Medication-Induced Akathisia with Newly Approved Antipsychotics in Patients with a Severe Mental Illness: A Systematic Review and Meta-Analysis.CNS drugs · 2019Pooled it
- Association of First- vs. Second-Generation Antipsychotics with Lipid Abnormalities in Individuals with Severe Mental Illness: A Systematic Review and Meta-Analysis.Clinical drug investigation · 2019Pooled it
- Atypical antipsychotics, insulin resistance and weight; a meta-analysis of healthy volunteer studies.Progress in neuro-psychopharmacology & biological psychiatry · 2018Pooled it
- Guidelines for the Pharmacotherapy of Schizophrenia in Adults.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2017Pooled it
- Treatment-Resistant Schizophrenia: Treatment Response and Resistance in Psychosis (TRRIP) Working Group Consensus Guidelines on Diagnosis and Terminology.The American journal of psychiatry · 2017Pooled it
- Industry sponsorship and research outcome.The Cochrane database of systematic reviews · 2017Pooled it
- The Incidence of Akathisia in the Treatment of Schizophrenia with Aripiprazole, Asenapine and Lurasidone: A Meta-Analysis.Current neuropharmacology · 2015Pooled it
- Incidence and risk factors of acute akathisia in 493 individuals with first episode non-affective psychosis: a 6-week randomised study of antipsychotic treatment.Psychopharmacology · 2017Trial
- Prescription practices in the treatment of first-episode schizophrenia spectrum disorders: data from the national RAISE-ETP study.The American journal of psychiatry · 2015Trial
- Psychosis in multiple sclerosis-a narrative review of an underestimated, but clinically significant problem.Journal of neural transmission (Vienna, Austria : 1996) · 2026Review
- Antipsychotic prescribing trends in England: role of regional disparities, health inequalities and ethnic density.BJPsych open · 2026Article
- Antipsychotic prescribing patterns and determinants in first-episode psychosis: a 2019-2024 cross-sectional study from Zambia.BMC psychiatry · 2026Article
- Prevalence and associated factors of antipsychotic-induced extrapyramidal symptoms in the Tigray region.BMC psychiatry · 2025Article
- Psychological side effects of antipsychotic medication after remission from first-episode psychosis: a HAMLETT ecological momentary assessment study.Psychological medicine · 2025Article
- Healthcare for individuals with schizophrenia in Taiwan: 10-year national trend analysis.BJPsych open · 2025Article
64 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
Because early treatment choice is critical in first-episode schizophrenia-spectrum disorders (FES), this meta-analysis compared efficacy and tolerability of individual second-generation antipsychotics (SGAs) with first-generation antipsychotics (FGAs) in FES. We conducted systematic literature search (until 12 December 2010) and meta-analysis of acute, randomized trials with ≥1 FGA vs. SGA comparison; patients in their first episode of psychosis and diagnosed with schizophrenia-spectrum disorders; available data for psychopathology change, treatment response, treatment discontinuation, adverse effects, or cognition. Across 13 trials (n = 2509), olanzapine (seven trials) and amisulpride (one trial) outperformed FGAs (haloperidol: 9/13 trials) in 9/13 and 8/13 efficacy outcomes, respectively, risperidone (eight trials) in 4/13, quetiapine (one trial) in 3/13 and clozapine (two trials) and ziprasidone (one trial) in 1/13, each. Compared to FGAs, extrapyramidal symptom (EPS)-related outcomes were less frequent with olanzapine, risperidone and clozapine, but weight gain was greater with clozapine, olanzapine and risperidone. Pooled SGAs were similar to FGAs regarding total psychopathology change, depression, treatment response and metabolic changes. SGAs significantly outperformed FGAs regarding lower treatment discontinuation, irrespective of cause, negative symptoms, global cognition and less EPS and akathisia, while SGAs increased weight more (p < 0.05-0.01). Results were not affected by FGA dose or publication bias, but industry-sponsored studies favoured SGAs more than federally funded studies. To summarize, in FES, olanzapine, amisulpride and, less so, risperidone and quetiapine showed superior efficacy, greater treatment persistence and less EPS than FGAs. However, weight increase with olanzapine, risperidone and clozapine and metabolic changes with olanzapine were greater. Additional FES studies including broader-based SGAs and FGAs are needed.
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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.