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Clinical relevance of findings in trials of antipsychotics: systematic review

  • Peter Lepping (a1), Rajvinder S. Sambhi (a2), Richard Whittington (a3), Steven Lane (a4) and Rob Poole (a5)...
Abstract
Background

There is concern over the methods used to evaluate antipsychotic drugs.

Aims

To assess the clinical relevance of findings in the literature.

Method

A systematic review identified studies of antipsychotics that used the Brief Psychiatric Rating Scale (BPRS) and Positive and Negative Syndrome Scale (PANSS). A published method of translating these into Clinical Global Impression – Change scale (CGI–C) scores was used to measure clinical relevance.

Results

In total 98 data-sets were included in the BPRS analysis and 202 data-sets in the PANSS analysis. When aggregated scores were translated into notional CGI–C scores, most drugs reached ‘minimal improvement’ on the BPRS, but few reached that level for PANSS. This was true of both first- and second-generation drugs, including clozapine. Amisulpride and olanzapine had better than average CGI–C scores.

Conclusions

Our findings show improvements of limited clinical relevance. The CGI–C scores were better for the BPRS than for the PANSS.

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Copyright
Corresponding author
Peter Lepping, MD, MRCPsych, MSc, Wrexham Academic Unit, Technology Park, Croesnewydd Road, Wrexham LL13 7YP. Email: peter.lepping@wales.nhs.uk
Footnotes
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Declaration of interest

P.L. has accepted speakers' honoraria for talks on medical ethics and capacity legislation from AstraZeneca and Ely Lilly. R.P. has accepted speakers' honoraria from Lundbeck, Janssen, Ely Lilly, AstraZeneca and Pfizer.

Footnotes
References
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Clinical relevance of findings in trials of antipsychotics: systematic review

  • Peter Lepping (a1), Rajvinder S. Sambhi (a2), Richard Whittington (a3), Steven Lane (a4) and Rob Poole (a5)...
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