Antipsychotic drugs for the acute treatment of patients with a first episode of schizophrenia

Clinicians remain divided over which antipsychotic drug is best to treat the first episode of schizophrenia, prompting researchers to consult the literature. Of 19 relevant randomized controlled trials published through November 17, 2016, 13 presented data on overall change in symptoms—the primary outcome.

Clinicians remain divided over which antipsychotic drug is best to treat the first episode of schizophrenia, prompting researchers to consult the literature. Of 19 relevant randomized controlled trials published through November 17, 2016, 13 presented data on overall change in symptoms—the primary outcome. The studies included several different medications, with amisulpride, olanzapine, ziprasidone, and risperidone appearing to be more effective than haloperidol for overall reduction of symptoms. Haloperidol was also outperformed by several second-generation drugs in terms of study dropout for inefficacy of treatment or any other reason. While haloperidol is seemingly a poor choice for acute treatment of first-episode schizophrenia, the overall quality of the evidence is low. Therefore, the researchers conclude, providers should base their choice of treatment primarily on adverse effects.