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Comparative effectiveness of second-generation antipsychotics and haloperidol in acute schizophrenia

Department of Psychiatry,Woodhull Medical and Mental Health Center, Brooklyn, New York, USA

Correspondence: Dr Robertt E. McCue, Department of Psychiatry, Wooodhull Medical and Mental Health Center, 760 Broadway, Brooklyn, New York 11206,USA. Email: mccuer{at}nychhc.org

Declaration of interest None.

See editorial, pp. 391–392, this issue.

Background There is little information on the comparative effectiveness of second-generation antipsychotic agents.

Aims To determine if any of five second-generation antipsychotics or haloperidolis more effective in treating acutely ill patients with schizophrenia, schizoaffective disorder or schizophreniform disorder.

Method A sample of 327 newly admitted patients were randomised to open-label treatment with aripiprazole, haloperidol, olanzapine, quetiapine, risperidone or ziprasidone for a minimum of 3 weeks. Measures of effectiveness were improvement in mental status so that the patient no longer required acute in-patient care, and changes in Brief Psychiatric Rating Scale (BPRS) scores.

Results By the first measure, haloperidol (89%), olanzapine (92%) and risperidone (88%) were significantly more effective than aripiprazole (64%), quetiapine (64%) and ziprasidone (64%). Changes in BPRS ratings were not significant among treatments.

Conclusions Haloperidol, olanzapine and risperidone are superior to aripiprazole, quetiapine and ziprasidone for the acute treatment of psychosis in hospitalised patients with schizophrenia, schizoaffective disorder or schizophreniform disorder.

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