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Chlorpromazine Versus Atypical Antipsychotic Drugs for Schizophrenia (Review)

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Chlorpromazine Versus Atypical Antipsychotic Drugs for Schizophrenia (Review) Cochrane Database of Systematic Reviews Chlorpromazine versus atypical antipsychotic drugs for schizophrenia (Review) Saha KB, Bo L, Zhao S, Xia J, Sampson S, Zaman RU SahaKB, Bo L, ZhaoS, Xia J, Sampson S,ZamanRU. Chlorpromazine versus atypical antipsychotic drugs for schizophrenia. Cochrane Database of Systematic Reviews 2016, Issue 4. Art. No.: CD010631. DOI: 10.1002/14651858.CD010631.pub2. www.cochranelibrary.com Chlorpromazine versus atypical antipsychotic drugs for schizophrenia (Review) Copyright © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. TABLE OF CONTENTS HEADER....................................... 1 ABSTRACT ...................................... 1 PLAINLANGUAGESUMMARY . 2 SUMMARY OF FINDINGS FOR THE MAIN COMPARISON . ..... 4 BACKGROUND .................................... 8 OBJECTIVES ..................................... 9 METHODS ...................................... 9 RESULTS....................................... 15 Figure1. ..................................... 17 Figure2. ..................................... 24 Figure3. ..................................... 25 Figure4. ..................................... 27 ADDITIONALSUMMARYOFFINDINGS . 45 DISCUSSION ..................................... 52 AUTHORS’CONCLUSIONS . 54 ACKNOWLEDGEMENTS . 55 REFERENCES ..................................... 55 CHARACTERISTICSOFSTUDIES . 65 DATAANDANALYSES. 150 Analysis 1.1. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 1 Clinical response: 1. No significant clinical response. 161 Analysis 1.2. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 2 Clinical response: 2. Average endpoint score (CGI, high = poor) - short term (up to 6 months). ............. 162 Analysis 1.3. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 3 Clinical response: 3. Relapse - longterm(over12months).. 163 Analysis 1.4. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 4 Mental state: 1. Average endpoint score (various scales, high = poor) - short term (up to 6 months). .............. 164 Analysis 1.5. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 5 Mental state: 2. Average endpoint score (BPRS, high = poor) - medium term (7 to 12 months). ........ 166 Analysis 1.7. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 7 Service involvement: 1. Re- hospitalisation. ... ... ... ... ... ... ... ... ... ... .. 168 Analysis 1.8. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 8 Functioning: 1. Executive function - average endpoint score (WCST, high = poor). ........... 168 Analysis 1.9. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 9 Adverse effects: 1. Anticholinergic -shortterm(upto6months). 169 Analysis 1.10. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 10 Adverse effects: 2. Cardiovascular - short term (up to 6 months). ....... 170 Analysis 1.11. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 11 Adverse effects: 3. Central nervous system - short term (up to 6 months). 172 Analysis 1.12. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 12 Adverse effects: 4. Gastrointestinal - short term (up to 6 months). ......... 173 Analysis 1.13. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 13 Adverse effects: 5. Haematology -shortterm(upto6months). 174 Analysis 1.14. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 14 Adverse effects: 6. Hepatitic - shortterm(upto6months). 175 Analysis 1.15. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 15 Adverse effects: 7a. Metabolic - weightgain-shortterm(upto6months). 176 Analysis 1.16. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 16 Adverse effects: 7b. Metabolic - weight gain - continuous measures. 177 Analysis 1.17. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 17 Adverse effects: 7c. Metabolic - other-continuousmeasures. 178 Chlorpromazine versus atypical antipsychotic drugs for schizophrenia (Review) i Copyright © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Analysis 1.19. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 19 Adverse effects: 8a. Movement disorders - extrapyramidal symptoms - short term (up to 6 months)................ 179 Analysis 1.20. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 20 Adverse effects: 8b. Movement disorders - extrapyramidal symptoms - average endpoint score(ESRS,high=poor).. 181 Analysis 1.21. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 21 Adverse effects: 9a. Various other - sleep - average endpoint score (LSEQ, high = better) - short term (up to 6 months). 182 Analysis 1.22. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 22 Adverse effects: 9b. Various other-sleep-averagelengthofsleep(hour/day). ............ 183 Analysis 1.24. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 24 Adverse effects: 9b. Various other-rash. .................................. 184 Analysis 1.25. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 25 Quality of life: 1a. Average endpoint scores (various scales, high = better) - short term (up to 6 months). 185 Analysis 1.27. Comparison 1 CHLORPROMAZINE versus OLANZAPINE, Outcome 27 Leaving the study early - short term(upto6months). 186 Analysis 2.1. Comparison 2 CHLORPROMAZINE versus RISPERIDONE, Outcome 1 Clinical response: 1. No significant clinical response. 187 Analysis 2.3. Comparison 2 CHLORPROMAZINE versus RISPERIDONE, Outcome 3 Global state: 2. Need of additionalbenzhexol. 188 Analysis 2.4. Comparison 2 CHLORPROMAZINE versus RISPERIDONE, Outcome 4 Mental state: 1a. Average endpoint score (various scales, high = poor) - short term (up to 6 months).. 189 Analysis 2.6. Comparison 2 CHLORPROMAZINE versus RISPERIDONE, Outcome 6 Mental state: 2. Average change score - decreased rate (various scales, high = poor) - short term (up to 6 months). 192 Analysis 2.7. Comparison 2 CHLORPROMAZINE versus RISPERIDONE, Outcome 7 Functioning: 1. Average endpoint score (WCST subscales, high = good) - short term (up to 6 months). .............. 193 Analysis 2.8. Comparison 2 CHLORPROMAZINE versus RISPERIDONE, Outcome 8 Adverse effects: 1. Anticholinergic -shortterm(upto6months). 194 Analysis 2.9. Comparison 2 CHLORPROMAZINE versus RISPERIDONE, Outcome 9 Adverse effects: 2a. Cardiovascular -shortterm(upto6months). 196 Analysis 2.10. Comparison 2 CHLORPROMAZINE versus RISPERIDONE, Outcome 10 Adverse effects: 2b. Cardiovascular - continuous measures - short term (up to 6 months)................ 198 Analysis 2.11. Comparison 2 CHLORPROMAZINE versus RISPERIDONE, Outcome 11 Adverse effects: 3. Central nervous system - short term (up to 6 months). 199 Analysis 2.12. Comparison 2 CHLORPROMAZINE versus RISPERIDONE, Outcome 12 Adverse effects: 4. Gastrointestinal - short term (up to 6 months). ......... 201 Analysis 2.13. Comparison 2 CHLORPROMAZINE versus RISPERIDONE, Outcome 13 Adverse effects: 5. Haematology -shortterm(upto6months). 203 Analysis 2.14. Comparison 2 CHLORPROMAZINE versus RISPERIDONE, Outcome 14 Adverse effects: 6. Hepatitic - shortterm(upto6months). 204 Analysis 2.15. Comparison 2 CHLORPROMAZINE versus RISPERIDONE, Outcome 15 Adverse effects: 7. Metabolic - weightgain. .................................. 205 Analysis 2.16. Comparison 2 CHLORPROMAZINE versus RISPERIDONE, Outcome 16 Adverse effects: 8. Movement disorders-shortterm(upto6months).. 206 Analysis 2.18. Comparison 2 CHLORPROMAZINE versus RISPERIDONE, Outcome 18 Adverse effects: 10. Various other-shortterm(upto6months). 208 Analysis 2.19. Comparison 2 CHLORPROMAZINE versus RISPERIDONE, Outcome 19 Quality of life: 1. Average endpointscore(QOL,high=good). 209 Analysis 2.20. Comparison 2 CHLORPROMAZINE versus RISPERIDONE, Outcome 20 Leaving the study early - short term(upto6months). 210 Analysis 3.1. Comparison 3 CHLORPROMAZINE versus QUETIAPINE, Outcome 1 Clinical response: 1. No significant clinicalresponse.. 211 Analysis 3.2. Comparison 3 CHLORPROMAZINE versus QUETIAPINE, Outcome 2 Global state: 1. Need of additional benzodiazepines/benzhexol. 212 Chlorpromazine versus atypical antipsychotic drugs for schizophrenia (Review) ii Copyright © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Analysis 3.3. Comparison 3 CHLORPROMAZINE versus QUETIAPINE, Outcome 3 Global state: 2a. Average endpoint scores (various scales, high = poor) - short term (up to 6 months). ............... 213 Analysis 3.5. Comparison 3 CHLORPROMAZINE versus QUETIAPINE, Outcome 5 Global state: 3. Average change scores(CGI-SI,high=poor). 214 Analysis 3.6. Comparison 3 CHLORPROMAZINE versus QUETIAPINE, Outcome 6 Mental state: 1a. Average endpoint scores (various scales, high = poor) - short term (up to 6 months). ............... 215 Analysis 3.7. Comparison 3 CHLORPROMAZINE versus QUETIAPINE, Outcome 7 Mental state: 1b. Average endpoint scores (various scales, high = poor) - medium term (6 to 12 months). ............... 219 Analysis 3.9. Comparison 3 CHLORPROMAZINE versus QUETIAPINE, Outcome 9 Mental state: 1d. Average change score (various scales, high = poor) - short term (up to 6 months). .............. 222 Analysis 3.10. Comparison 3 CHLORPROMAZINE versus QUETIAPINE, Outcome 10 Mental state: 1e. Average score decreased rate of BPRS/PANSS (%) - short term (up to 6 months). ............ 223 Analysis 3.11. Comparison 3 CHLORPROMAZINE versus QUETIAPINE, Outcome 11 Functioning: 1. Average endpoint score (various scales, high = better) - short term (up to 6 months). 224 Analysis 3.12. Comparison 3 CHLORPROMAZINE versus QUETIAPINE, Outcome 12 Cognitive function: 1. Average endpoint score (various scales, high = better)
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