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With schizophrenia imposing high costs and disability, the relative risks, benefits, and costs of the various antipsychotic drugs continue to be hotly debated. This multitreatments meta-analysis integrates the results of 212 clinical trials, covering 15 antipsychotic drugs and placebo, in 43,049 actively ill but not treatment-resistant schizophrenia patients. The method included direct comparisons and indirect ones where the relative effects of two medications in different trials were inferred from effects against a common comparator.
Standardized mean differences (SMDs) in efficacy against positive and negative symptoms in placebo comparisons varied widely (e.g., clozapine, 0.88; amisulpride, 0.66; olanzapine, 0.59; risperidone, 0.56; luras…