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Since its reintroduction to clinical practice more than 25 years ago, clozapine has been considered more effective than other antipsychotics for refractory schizophrenia. To verify this belief, investigators used “network meta-analysis,” which allows comparisons of drugs from different studies if they shared a comparator, and analyzed 40 double- or single-blind, randomized trials of any antipsychotic compared with another antipsychotic or placebo in 5172 patients (mean age, 39).
Treatment resistance was defined variably as failure to respond (<20% reduction in symptom-rating scale score) to past treatment lasting ≥3 weeks with one or two antipsychotic drugs or no response according to combined retrospective and prospective measures.
Individua…