Selection of Atypical Antipsychotics for the Management of Schizophrenia

OBJECTIVETo review the evidence for selecting one atypical antipsychotic agent over another for management of schizophrenia.DATA SOURCESA literature search of MEDLINE (1966–June 2003), EMBASE (1998–June 2003), and the Cochrane Library was conducted using the following terms: schizophrenia, quetiapine, ziprasidone, olanzapine, aripiprazole, and risperidone. Bibliographies of relevant articles were hand-searched for additional references.STUDY SELECTION AND DATA EXTRACTIONProspective, randomized, blinded trials and meta-analyses that directly or indirectly compared ≥2 atypical antipsychotic agents in the management of schizophrenia are included in this review. Studies comparing an atypical agent with clozapine are not included.DATA SYNTHESISA small number of prospective, randomized, blinded trials that compare efficacy and tolerability of olanzapine and risperidone have been published. These trials did not reveal clinically meaningful differences in efficacy but did confirm that their adverse effect profile...