Comparing the efficacy of atypical antipsychotics in open uncontrolled versus double-blind controlled trials in schizophrenia

Psychopharmacology (Berl). 2002 Jun;162(1):29-36. doi: 10.1007/s00213-002-1055-9. Epub 2002 Apr 19.

Abstract

Objective: Due to methodological reservations, open clinical trials investigating efficacy and tolerability of antipsychotic agents are often regarded with doubt. However, there are nearly no studies comparing findings of controlled double-blind with those of open trials. The aim of this study was to investigate whether results of open and double-blind approaches differ and thereby gain information about the validity of open trials.

Methods: After literature research, three atypical antipsychotic agents were identified for which at least three open and double-blind trials existed that met the inclusion criteria and from which either the reduction of the Brief Psychiatric Rating Scale (BPRS)- or Positive and Negative Symptom Scale (PANSS) scores or the response rate could be determined.

Results: There were no differences in the reduction of the BPRS- or PANSS scores or in the response rates for all three antipsychotic agents between open and double-blind trials.

Conclusions: Although double-blind controlled studies are essential in the investigation of new compounds, results of methodologically well-performed open studies are valid and deserve more attention. Preceding open trials may help in the design of double-blind studies.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Antipsychotic Agents / therapeutic use*
  • Controlled Clinical Trials as Topic / methods
  • Controlled Clinical Trials as Topic / statistics & numerical data*
  • Dibenzothiepins / therapeutic use
  • Double-Blind Method
  • Humans
  • Remoxipride / therapeutic use
  • Risperidone / therapeutic use
  • Statistics, Nonparametric

Substances

  • Antipsychotic Agents
  • Dibenzothiepins
  • Remoxipride
  • Risperidone
  • zotepine