Effectiveness of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder: an open randomised clinical trial

Abstrakt

We aimed to compare the effectiveness of second-generation antipsychotic drugs with that of a low dose of haloperidol, in first-episode schizophrenia.We did an open randomised controlled trial of haloperidol versus second-generation antipsychotic drugs in 14 countries.498 patients were randomly assigned by a web-based online system to haloperidol, amisulpride, olanzapine, quetiapine or ziprasidone; follow-up was at 1 year. The primary outcome measure was all-cause treatment discontinuation.

The number of patients who discontinued treatment for any cause within 12 months was 63 (Kaplan-Meier estimate 72%) for haloperidol, 32 (40%) for amisulpride, 30 (33%) for olanzapine, 51 (53%) for quetiapine, and 31 (45%) for ziprasidone. Comparisons with haloperidol showed lower risks for any-cause discontinuation with amisulpride, olanzapine, quetiapine, and ziprasidone.