A Meta-Analysis of Randomized Control Trial on the Efficacy of Second Generation Antipsychotics

Abstract

Over the past decade, second-generation antipsychotic medications have become the first-line treatment for schizophrenia. But efficacy of second generation antipsychotic compared with first generation antipsychotic in patients with schizophrenia has not been sufficiently addressed. The study objective was to perform a meta-analysis of randomized trials compare the efficacy of second generation antipsychotic (SGAs) vs. first generation antipsychotics (FGAs). Searches were conducted for randomized, blinded studies comparing one or more of nine second- generation antipsychotics in the treatment of schizophrenia with first generation antipsychotic which published from 2003 till 2013 from nature, Pubmed central, and henari website. The primary outcome measure was change in total score on the Positive and Negative Syndrome Scale; secondary outcome measures were positive and negative symptom subs cores. The results were combined in comprehensive meta- analysis version 2 software. The analysis included 9 studies, the meta-analysis comparing FGAs and SGAs using change in total PANSS, score, the odds ratio is 1.407 with 95 % confidence interval of 1.016-1.948 z- value of 2.055 and p-value 0.04(p<0.05) indicating the result of analysis is statistically significant. The odds ratio is falls above 1 indicating the patient treated with second generation antipsychotic were more likely reduce total PANSS score than first generation antipsychotic. In conclusion, Second generation antipsychotic is superior in reducing total PANSS score than first generation antipsychotic. Regard to resperidone and olanzapine, they are homogenous in reducing total PANSS score.

Keywords: Efficacy, antipsychotic, second generation antipsychotic, first generation antipsychotic, PANSS score, meta-analysis.