Abstract | BACKGROUND: In many countries of the industrialised world, second generation (atypical) antipsychotic drugs have become first line treatment for people with schizophrenia. The question as to whether the effects of various second generation antipsychotic drugs differ is a matter of debate. In this review we examined how the efficacy and tolerability of zotepine differs from that of other second generation antipsychotic drugs. OBJECTIVES: SEARCH STRATEGY: We searched the Cochrane Schizophrenia Group Trials Register (April 2007) which is based on regular searches of BIOSIS, CENTRAL CINAHL, EMBASE, MEDLINE and PsycINFO. SELECTION CRITERIA: DATA COLLECTION AND ANALYSIS: We extracted data independently. For dichotomous data we calculated relative risks (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis based on a random effects model. We calculated numbers needed to treat/harm (NNT/NNH) where appropriate. For continuous data, we calculated weighted mean differences (MD) again based on a random effects model. MAIN RESULTS: The review currently includes data from two short term, ill reported trials (total n=109). Both studies compared zotepine with clozapine. 34% of people left early but there was no significant difference between groups. Zotepine was less effective than clozapine (no clinically significant response: n=59, 1 RCT, RR 8.23 CI 1.14 to 59.17, NNH 3 CI 2 to 8; average score (BPRS total) at endpoint (n=59, 1 RCT, MD 6.00 CI 2.17 to 9.83). Zotepine induced more movement disorders than clozapine (use of antiparkinson medication: n=59, 1 RCT, RR 18.75 CI 1.17 to 301.08, NNH 3 CI 2 to 5) and higher prolactin levels (n=59, 1 RCT, MD 33.40 CI 14.87 to 51.93). Data on important other outcomes such as other adverse events, service use or satisfaction with care were not available. AUTHORS' CONCLUSIONS:
|
Authors | Katja Komossa, Christine Rummel-Kluge, Heike Hunger, Franziska Schmid, Sandra Schwarz, Werner Kissling, Stefan Leucht |
Journal | The Cochrane database of systematic reviews
(Cochrane Database Syst Rev)
Issue 1
Pg. CD006628
(Jan 20 2010)
ISSN: 1469-493X [Electronic] England |
PMID | 20091601
(Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
|
Chemical References |
- Antipsychotic Agents
- Dibenzothiepins
- Clozapine
- zotepine
|
Topics |
- Antipsychotic Agents
(adverse effects, therapeutic use)
- Clozapine
(adverse effects, therapeutic use)
- Dibenzothiepins
(adverse effects, therapeutic use)
- Humans
- Randomized Controlled Trials as Topic
- Schizophrenia
(drug therapy)
|