PMID- 24308507
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20131217
LR  - 20211021
IS  - 1755-7682 (Print)
IS  - 1755-7682 (Electronic)
IS  - 1755-7682 (Linking)
VI  - 6
IP  - 1
DP  - 2013 Dec 5
TI  - Efficacy and tolerability of quetiapine versus haloperidol in first-episode 
      schizophrenia: a randomized clinical trial.
PG  - 47
LID - 10.1186/1755-7682-6-47 [doi]
AB  - BACKGROUND: Schizophrenia is a chronic disease of global importance. The 
      second-generation antipsychotic quetiapine has a favorable side-effect profile, 
      however, its clinical effectiveness has been called into question when compared 
      with first-generation antipsychotics such as haloperidol. This study evaluates 
      the efficacy and tolerability of quetiapine versus haloperidol for first-episode 
      schizophrenia in the outpatient setting. METHODS: 156 adult patients with 
      first-episode schizophrenia participated in an outpatient clinical trial and were 
      randomized to quetiapine (200 mg/d; n = 78) or haloperidol (5 mg/d; n = 78). The 
      study medications were titrated to a mean daily dose of 705 mg for quetiapeine 
      and 14 mg for haloperidol. The patients were assessed at baseline, six weeks, and 
      twelve weeks. The primary outcome measures were positive and negative scores of 
      the Positive and Negative Syndrome Scale (PANSS). Secondary measures were Global 
      Assessment of Functioning (GAF) scale for overall psychosocial functioning, and 
      Simpson-Angus Scale (SAS) for extra-pyramidal symptoms. RESULTS: At twelve weeks, 
      the quetiapine group had a greater decrease in PANSS positive (18.9 vs. 15.3, p = 
      0.013) and negative scores (15.5 vs. 11.6, p = 0.012), however, haloperidol 
      showed a greater decrease in general psychopathology score (23.8 vs. 27.7, p = 
      0.012). No significant difference between groups were found for total PANSS (58.3 
      vs. 54.8, p = 0.24) and GAF (45.7 vs. 46.2, p = 0.79).ANOVA identified 
      significant group interactions on PANSS positive (F = 18.72, df = 1.6,52.4, p < 
      0.0001), negative (F = 5.20, df = 1.1,35.7, p < 0.0001), depression/anxiety (F = 
      106.49, df = 1.14,37.8, p < 0.0001), and total scores (F = 7.51, df = 1.4,45.6, p 
      = 0.001).SAS (8.62 vs. 0.26, p < 0.0001) and adverse events of akathisia (78% vs. 
      0%, p = 0.000), parkinsonism (66.6% vs. 0%, p < 0.0001), and fatigue (84.6% vs. 
      66.6%, p = 0.009) were greater in haloperidol compared to quetiapine, whereas 
      headache was more common in quetiapine treated patients (11.5% vs. 35.9%, p < 
      0.0001). CONCLUSIONS: Quetiapine has greater efficacy for positive and negative 
      symptoms with less extra-pyramidal symptoms than haloperidol when used for 
      first-episode schizophrenia in the outpatient setting.
FAU - Amr, Mostafa
AU  - Amr M
FAU - Lakhan, Shaheen E
AU  - Lakhan SE
AD  - Global Neuroscience Initiative Foundation, Beverly Hills, CA, USA. 
      slakhan@gnif.org.
FAU - Sanhan, Sarila
AU  - Sanhan S
FAU - Al-Rhaddad, Dahoud
AU  - Al-Rhaddad D
FAU - Hassan, Moussa
AU  - Hassan M
FAU - Thiabh, Mohamed
AU  - Thiabh M
FAU - Shams, Tarek
AU  - Shams T
LA  - eng
PT  - Journal Article
DEP - 20131205
PL  - England
TA  - Int Arch Med
JT  - International archives of medicine
JID - 101317943
PMC - PMC4174907
EDAT- 2013/12/07 06:00
MHDA- 2013/12/07 06:01
PMCR- 2013/12/05
CRDT- 2013/12/07 06:00
PHST- 2013/04/02 00:00 [received]
PHST- 2013/11/07 00:00 [accepted]
PHST- 2013/12/07 06:00 [entrez]
PHST- 2013/12/07 06:00 [pubmed]
PHST- 2013/12/07 06:01 [medline]
PHST- 2013/12/05 00:00 [pmc-release]
AID - 1755-7682-6-47 [pii]
AID - 10.1186/1755-7682-6-47 [doi]
PST - epublish
SO  - Int Arch Med. 2013 Dec 5;6(1):47. doi: 10.1186/1755-7682-6-47.