RISPERIDONE VERSUS HALOPERIDOL - I - METAANALYSIS OF EFFICACY AND SAFETY

Haloperidol is widely considered a reference standard in antipsychotic therapy and is commonly used in comparative studies of the efficacy a nd safety of antipsychotic medication Comparative clinical trials have shown that the novel antipsychotic agent risperidone tends to have gr eater efficacy lie, clinical response defined as a greater than or equ al to 20% reduction in total scores on the Positive and Negative Syndr ome Scale) than haloperidol in patients with chronic schizophrenia and poses less risk of extrapyramidal symptoms (EPS). We used DerSimonian and Laird's random-effects model to analyze pooled patient data from available randomized, double-masked, comparative trials of risperidone and haloperidol in patients with schizophrenia treated for at least 4 weeks al recommended doses. The purpose of the analysis was to determ ine whether there are significant overall differences in the rates of patient clinical response, prescription of anticholinergic agents, and treatment dropout. Six of the nine trials revealed in a literature se arch met all criteria for inclusion in the meta-analysis. The meta-ana lysis showed that in patients with chronic schizophrenia, risperidone therapy is associated with significantly higher response rates, signif icantly less prescribing of anticholinergic medication, and significan tly lower treatment dropout rates than haloperidol. These results demo nstrate the greater treatment efficacy associated with risperidone com pared with haloperidol and suggest both a lower incidence of EPS and i mproved treatment compliance.