This paper is only available as a PDF. To read, Please Download here.
Haloperidol is widely considered a reference standard in antipsychotic therapy and is commonly used in comparative studies of the efficacy and safety of antipsychotic medication. Comparative clinical trials have shown that the novel antipsychotic agent risperidone tends to have greater efficacy (ie, clinical response defined as a ≥20% reduction in total scores on the Positive and Negative Syndrome 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 at recommended doses. The purpose of the analysis was to determine 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 search met all criteria for inclusion in the meta-analysis. The meta-analysis showed that in patients with chronic schizophrenia, risperidone therapy is associated with significantly higher response rates, significantly less prescribing of anticholinergic medication, and significantly lower treatment dropout rates than haloperidol. These results demonstrate the greater treatment efficacy associated with risperidone compared with haloperidol and suggest both a lower incidence of EPS and improved treatment compliance.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Clinical Therapeutics
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Pharmacology of risperidone (R64 766), a new antipsychotic with serotonin-S2 and dopamine-D2 antagonist properties.J Pharmacol Exp Ther. 1988; 244: 685-693
- Biochemical profile of risperidone, a new antipsychotic.J Pharmacol Exp Ther. 1988; 247: 661-670
- Mechanism of the antipsychotic effect in the treatment of acute schizophrenia.Lancet. 1978; 1: 848-851
- Risperidone compared with new and reference antipsychotic drugs—in vitro and in vivo receptor binding.Psychopharmacology. 1996; 124: 57-73
- Risperidone versus haloperidol versus placebo in the treatment of schizophrenia.Clinical Research Report on R64766 RIS-USA-9001. Janssen Pharmaceutica, Beerse, Belgium1991
- A Canadian multicenter placebo-controlled study of fixed doses of risperidone and haloperidol in the treatment of chronic schizophrenic patients.J Clin Psychopharmacol. 1993; 13: 25-40
- Risperidone in the treatment of schizophrenia.Am J Psychiatry. 1994; 151: 825-835
- Risperidone in the treatment of patients with chronic schizophrenia: A multinational, multicenter, double-blind, parallel-group study versus haloperidol.Br J Psychiatry. 1995; 166: 712-716
- Risperidone versus haloperidol in the treatment of chronic schizophrenia in inpatients: A multicenter, double-blind comparative study.Acta Psychiatr Scand. 1992; 85: 295-305
- Antipsychotic and anxiolytic properties of risperidone, haloperidol, and methotrimeprazine in schizophrenic patients.J Clin Psychopharmacol. 1996; 16: 38-44
- Meta-analysis and its problems.Br Med J. 1994; 309: 789-792
- Can meta-analysis be trusted?.Lancet. 1991; 338: 1127-1130
- Have you ever meta-analysis you didn't like?.Ann Intern Med. 1991; 114: 244-246
- Meta-analysis in clinical research.Ann Intern Med. 1987; 107: 224-233
- Meta-analysis in clinical trials.Control Clin Trials. 1986; 7: 177-188
- The Positive and Negative Syndrome Scale (PANSS) for schizophrenia.Schizophr Bull. 1987; 16: 261-276
- The Brief Psychiatric Rating Scale.Psychol Rep. 1962; 10: 799-812
- Double-blind comparison of risperidone and haloperidol in schizophrenic and schizoaffective psychoses.Pharmacopsychiatry. 1993; 26: 121-124
- Risperidone versus haloperidol in the treatment of chronic schizophrenic patients: A parallel group, double-blind comparative trial.Yonsei Med J. 1993; 34: 179-190
- Risperidone versus haloperidol in chronic psychotic patients: A multicentre double-blind study.Clinical Research Report on RIS-BEL-7. Janssen Research Foundation, Beerse, Belgium1991
- Terapija psichiceeskich zabolevanij.Medgiz Moskva. 1948;
- Risperidone versus haloperidol: II. Cost-effectiveness.Clin Ther. 1997; 19: 196-213
Risperdal approved product information. Janssen-Cilag Pty. Ltd., Lane Cove, New South Wales, Australia.
- Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association, Washington, DC1987: 187-198 (revised) 3rd ed.
- Manual of the International Classification of Diseases, Injuries and Causes of Death Based on the Recommendations of the Ninth Revision Conference. World Health Organization, Geneva1977: 182-185
- Risperidone in the treatment of negative symptoms of schizophrenia: A meta-analysis.Int Clin Psychopharmacol. 1995; 10: 207-213
- The Extrapyramidal Rating Scale.Can J Neurol Sci. 1980; 73: 233
- Risperidone.Am J Psychiatry. 1994; 151: 802-803
- 2nd ed. Victorian Drug Usage Advisory Committee Psychotropic Drug Guidelines 1993. Victorian Medical Postgraduate Foundation, Inc, North Melbourne, Australia1993: 68
- Reynolds JEF 31st ed. Martindale: The Extra Pharmacopoiea. Royal Pharmaceutical Society, London1996: 714-715
- Treatment of schizophrenia.J Clin Psychiatry. 1996; 57 (Suppl 12B): 25
- Australian Medical Index. 4. IMS Australia, Australia1994 (Crows Nest)
- A controlled dose comparison of haloperidol in newly admitted schizophrenic patients.Arch Gen Psychiatry. 1990; 47: 754-758
- Risperidone safety and efficacy.Schizophr Bull. 1995; 21: 593-606
- Clinical efficacy of serotonin-dopamine antagonists relative to classical neuroleptics.J Clin Psychopharmacol. 1995; 15 (Suppl 1): 24S-29S
- Meta-analysis of relative efficacy and side effects of risperidone in the treatment of schizophrenia.Pharmacoepidemiol Drug Saf. 1995; 4 (Abstract): S5
© 1998 Published by Elsevier Inc.