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Clinical
Profile of an Atypical Antipsychotic: Risperidone Meta-Analysis
of the effect of acute or chronic status on differential outcome to
risperidone and haloperidol
Means and standard deviations of the improvement scores were available for 19 studies (Figure 6 of manuscript). We used the Hedges-Olkin method with Comprehensive Meta Analysis (1.0.16; Borenstein and Rothstein 1999) of the randomized studies to demonstrate that risperidone is superior to typical narcoleptics with an effect size of 0.26 (95% C.I.: 0.19-0.33; t = 7.3; p = 3 x 10-12. Two of the studies (Emsley et al. 1999 and Blin et al. 1996) used relatively acute symptomatic patients but there was no significant difference of acute versus chronic status (Q = 0.2, df = 1, p = NS). Fifteen studies reported means and standard deviations of the improvement scores observed with risperidone and typical neuroleptics for the positive and negative subscale. Our meta-analysis using Comprehensive Meta Analysis's implementation of the Hedges and Olkin algorithm found that risperidone produced significantly more improvement than typicals with the effect size of 0.16 for positive symptoms and 0.20 for negative symptoms (p = 10-5 and 10-7, respectively; Table 3). We also examined whether the risperidone-versus-typical difference was different in studies using acute patients versus the 12 studies using chronic patients. Differences on the total score and both positive and negative symptoms were not significant, with the Q statistic approximating zero (total score: Q = 0.2, df = 1, p = 0.65; positive symptoms: Q = 0.01, df = 1, p = 0.93; and negative symptoms: Q = 0.2, df = 1, p = 0.66). References: Borenstein, M., and Rothstein, H. Comprehensive Meta-analysis: A computer program for research synthesis. Englewood, N.J.: Biostat, 1999. Emsley, R.A. Risperidone in the treatment of first-episode psychotic patients: a double-blind multicenter study. Risperidone Working Group. Schizophrenia Bulletin, 25(4):721-729, 1999. |
