Healthy Skepticism Library item: 1911
Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.
Publication type: Journal Article
Moncrieff J.
Clozapine v. conventional antipsychotic drugs for treatment-resistant schizophrenia: a re-examination
Br J Psychiatry. 2003 Aug; 183:161-6
http://bjp.rcpsych.org/cgi/content/full/183/2/161
Abstract:
BACKGROUND: Although there is a consensus that clozapine is more effective than conventional antipsychotic drugs for treatment-resistant schizophrenia, there is great heterogeneity among results of relevant trials.
AIMS: To re-evaluate the evidence comparing clozapine with conventional antipsychotics and to investigate sources of heterogeneity.
METHOD: Individual studies were inspected with assessment of clinical relevance of results. Meta-regression analysis was performed to investigate sources of heterogeneity.
RESULTS: Ten trials were examined. Recent large-scale studies have not found a substantial advantage for clozapine, especially in terms of a clinically relevant effect. Meta-regression showed that shorter study duration, financial support from a drug company and higher baseline symptom score consistently predicted greater advantage of clozapine.
CONCLUSIONS: It may be inappropriate to combine studies in meta-analysis, given the degree of heterogeneity between their findings. The benefits of clozapine compared with conventional treatment may not be substantial.
Keywords:
Antipsychotic Agents/therapeutic use*
Clozapine/therapeutic use*
Comparative Study
Drug Industry
Financial Support
Humans
Patient Readmission
Randomized Controlled Trials/standards
Schizophrenia/drug therapy*
Time Factors
Treatment Failure
Treatment Outcome
