新一代抗精神病药物与传统抗精神病药物低效力:系统回顾和荟萃分析。
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Leucht年代,Wahlbeck K,哈曼J, Kissling W
新一代抗精神病药物与传统抗精神病药物低效力:系统回顾和荟萃分析。
柳叶刀》。2003年5月10日,361 (9369):1581 - 9。
- PubMed ID
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12747876 (在PubMed]
- 文摘
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背景:新一代的明显优势,非典型抗精神病药物是锥体外系副作用的风险降低(EPS),相比之下,传统的化合物。这些发现可能是偏见的使用强效抗精神病药物氟哌啶醇的比较器在大多数试验。我们旨在建立新药是否引起每股收益少于传统抗精神病药物低效力。方法:我们做了一个随机对照试验的荟萃分析的新一代抗精神病药物一直较低效力强大的(相当于或低于氯丙嗪)常规药物。我们包括研究符合质量标准的A或B Cochrane协作手册,并与Jadad量表评估质量。感兴趣的主要结果是病人的数目至少一个每股收益。我们使用的风险差异和95%独联体作为效果的措施。结果:我们发现31个研究共有2320名参与者。新一代的药物,只有氯氮平与每股收益明显减少(RD = -0.15, 95% CI -0.26到-0.4,p = 0.008)和更高的功效比低效力的常规药物。降低频率的EPS与奥氮平的边缘意义(-0.15,-0.31,-0.01,p = 0.07)。 Only one inconclusive trial of amisulpride, quetiapine, and risperidone and no investigations of ziprasidone and sertindole were identified, but some evidence indicates that zotepine and remoxipride do not lead to fewer EPS than low-potency antipsychotics. Mean doses less than 600 mg/day of chlorpromazine or its equivalent had no higher risk of EPS than new generation drugs. As a group, new generation drugs were moderately more efficacious than low-potency antipsychotics, largely irrespective of the comparator doses used. INTERPRETATION: Optimum doses of low-potency conventional antipsychotics might not induce more EPS than new generation drugs. Potential advantages in efficacy of the new generation drugs should be a factor in clinical treatment decisions to use these rather than conventional drugs.
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- 药物