Depressive Symptomatology:Comparative Evaluation of Typical Versus Atypical Antipsychotics in Schizophrenic Patients Using MADRS Scale

OBJECTIVE: To evaluate the efficacy among conventional antipsychotics Haloperidol, Thioridazine versus newer atypical antipsychotic agents  Olanzapine, Risperidone on depressive symptomatology in Schizophrenic patients . MATERIAL AND METHODS: An open label randomized prospective study was conducted in stable Schizophrenics for 12 weeks.A total no of 40 patients diagnosed according to DSM- IV criteria  were divided into 4 groups.  Group I(n=10) received  haloperidol 5-20 mg/day. Group II(n=10) received thioridazine 50-800mg/day. Group III(n=10) received Olanzapine 5-20mg/day. Group IV(n=10) received Risperidone 1-12mg/day. Evaluation of changes on depressive symptomatology done by MADRS scores. RESULTS: Intra group comparison showed significant   reduction   (p<0.001) that is,  (31.6±1.14 to 22.2±1.01)  and  (29.2±1.37 to 23.1±0.60) in the haloperidol and thioridazine  group  at the end of study. Intragroup  comparison  showed significant  reduction (p<0.001)  that  is  (29.8±0.81 to 15.2±0.53)  and  (30±0.94 to 18.4±0.66)  in  the  olanzapine  and  risperidone  group  at  the  end of  study.  Pronounced  effects  were  observed from  3 weeks  onwards  with both the newer antipsychotics. Intergroup  comparison  between  olanzapine, risperidone  as against  haloperidol and  thioridazine was significant (p<0.001) at the end of 6 and 12 weeks and that between olanzapine and risperidone at the end of 6 weeks (p<0.05) and  12 weeks (P<0.001) respectively. CONCLUSION: Olanzapine and risperidone exhibited faster and greater improvement in depressive symptoms as compared to the conventional antipsychotics. Further, olanzapine is superior to risperidone in this scale.