Clinical relevance of findings in trials of antipsychotics: systematic review

Br J Psychiatry. 2011 May;198(5):341-5. doi: 10.1192/bjp.bp.109.075366.

Abstract

Background: There is concern over the methods used to evaluate antipsychotic drugs.

Aims: To assess the clinical relevance of findings in the literature.

Method: A systematic review identified studies of antipsychotics that used the Brief Psychiatric Rating Scale (BPRS) and Positive and Negative Syndrome Scale (PANSS). A published method of translating these into Clinical Global Impression - Change scale (CGI-C) scores was used to measure clinical relevance.

Results: In total 98 data-sets were included in the BPRS analysis and 202 data-sets in the PANSS analysis. When aggregated scores were translated into notional CGI-C scores, most drugs reached 'minimal improvement' on the BPRS, but few reached that level for PANSS. This was true of both first- and second-generation drugs, including clozapine. Amisulpride and olanzapine had better than average CGI-C scores.

Conclusions: Our findings show improvements of limited clinical relevance. The CGI-C scores were better for the BPRS than for the PANSS.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Antipsychotic Agents / classification
  • Antipsychotic Agents / therapeutic use*
  • Clinical Trials as Topic
  • Data Interpretation, Statistical
  • Humans
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Placebos
  • Psychiatric Status Rating Scales / statistics & numerical data*
  • Psychotic Disorders / drug therapy
  • Schizophrenia / drug therapy*
  • Severity of Illness Index

Substances

  • Antipsychotic Agents
  • Placebos