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Abstract
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.
Keywords
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© 1998 Published by Elsevier Inc.
