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Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 1 Leaving the study early due to any reason.
Figures and Tables -
Analysis 1.1

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 1 Leaving the study early due to any reason.

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 2 Global state: 1. No clinically significant change (CGI < much improved).
Figures and Tables -
Analysis 1.2

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 2 Global state: 1. No clinically significant change (CGI < much improved).

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 3 Global state: 2. Need of additional medication (at least one dose of benzodiazepine).
Figures and Tables -
Analysis 1.3

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 3 Global state: 2. Need of additional medication (at least one dose of benzodiazepine).

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 4 Mental state: 1. General a. No clinically significant improvement ‐ as defined by each of the studies.
Figures and Tables -
Analysis 1.4

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 4 Mental state: 1. General a. No clinically significant improvement ‐ as defined by each of the studies.

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 5 Mental state: 1. General b. Various measures of change.
Figures and Tables -
Analysis 1.5

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 5 Mental state: 1. General b. Various measures of change.

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 6 Mental state: 1. General c. Average change (PANSS endpoint, low=poor).
Figures and Tables -
Analysis 1.6

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 6 Mental state: 1. General c. Average change (PANSS endpoint, low=poor).

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 7 Mental state: 1. General d. Average change (BPRS endpoint, low=poor).
Figures and Tables -
Analysis 1.7

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 7 Mental state: 1. General d. Average change (BPRS endpoint, low=poor).

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 8 Mental state: 2. Specific a. Positive symptoms ‐ average change (PANSS positive subscore endpoint, low=poor).
Figures and Tables -
Analysis 1.8

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 8 Mental state: 2. Specific a. Positive symptoms ‐ average change (PANSS positive subscore endpoint, low=poor).

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 9 Mental state: 2. Specific b. Positive symptoms ‐ average change (BPRS positive subscore endpoint, low=poor).
Figures and Tables -
Analysis 1.9

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 9 Mental state: 2. Specific b. Positive symptoms ‐ average change (BPRS positive subscore endpoint, low=poor).

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 10 Mental state: 2. Specific c. Negative symptoms ‐ average change (PANSS negative subscore endpoint, low=poor).
Figures and Tables -
Analysis 1.10

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 10 Mental state: 2. Specific c. Negative symptoms ‐ average change (PANSS negative subscore endpoint, low=poor).

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 11 Mental state: 2. Specific d. Negative symptoms ‐ average change (BPRS negative subscore endpoint, low=poor).
Figures and Tables -
Analysis 1.11

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 11 Mental state: 2. Specific d. Negative symptoms ‐ average change (BPRS negative subscore endpoint, low=poor).

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 12 Mental state: 2. Specific e. Depressive symptoms ‐ average change (MADRS endpoint, low=poor).
Figures and Tables -
Analysis 1.12

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 12 Mental state: 2. Specific e. Depressive symptoms ‐ average change (MADRS endpoint, low=poor).

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 13 Adverse events: 1. General a. At least one adverse event.
Figures and Tables -
Analysis 1.13

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 13 Adverse events: 1. General a. At least one adverse event.

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 14 Adverse events: 2. Extrapyramdial problems a. General i. Needing anticholinergic medication at least once.
Figures and Tables -
Analysis 1.14

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 14 Adverse events: 2. Extrapyramdial problems a. General i. Needing anticholinergic medication at least once.

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 15 Adverse events: 2. Extrapyramdial problems a. General ii. Not improved (SAS total >3).
Figures and Tables -
Analysis 1.15

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 15 Adverse events: 2. Extrapyramdial problems a. General ii. Not improved (SAS total >3).

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 16 Adverse events: 2. Extrapyramdial problems a. General iii. Average change (SAS, low=poor).
Figures and Tables -
Analysis 1.16

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 16 Adverse events: 2. Extrapyramdial problems a. General iii. Average change (SAS, low=poor).

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 17 Adverse events: 2. Extrapyramdial problems b. Specific i. Akathisia.
Figures and Tables -
Analysis 1.17

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 17 Adverse events: 2. Extrapyramdial problems b. Specific i. Akathisia.

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 18 Adverse events: 2. Extrapyramdial problems b. Specific ii. Akathisia ‐ average change (BAS, low=poor).
Figures and Tables -
Analysis 1.18

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 18 Adverse events: 2. Extrapyramdial problems b. Specific ii. Akathisia ‐ average change (BAS, low=poor).

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 19 Adverse Events: 2. Extrapyramdial problems b. Specific iii. Others.
Figures and Tables -
Analysis 1.19

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 19 Adverse Events: 2. Extrapyramdial problems b. Specific iii. Others.

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 20 Adverse events: 3. Others.
Figures and Tables -
Analysis 1.20

Comparison 1 NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL), Outcome 20 Adverse events: 3. Others.

Comparison 1. NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Leaving the study early due to any reason Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 due to any reason ‐ olanzapine

1

83

Risk Ratio (M‐H, Fixed, 95% CI)

0.43 [0.26, 0.73]

1.2 due to any reason ‐ risperidone

1

183

Risk Ratio (M‐H, Fixed, 95% CI)

0.65 [0.39, 1.08]

1.3 due to adverse effects ‐ olanzapine

1

83

Risk Ratio (M‐H, Fixed, 95% CI)

0.10 [0.01, 0.86]

1.4 due to adverse effects ‐ risperidone

1

183

Risk Ratio (M‐H, Fixed, 95% CI)

0.34 [0.14, 0.84]

2 Global state: 1. No clinically significant change (CGI < much improved) Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 risperidone

1

183

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.63, 1.54]

3 Global state: 2. Need of additional medication (at least one dose of benzodiazepine) Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 olanzapine

1

83

Risk Ratio (M‐H, Fixed, 95% CI)

0.76 [0.52, 1.11]

4 Mental state: 1. General a. No clinically significant improvement ‐ as defined by each of the studies Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 olanzapine

1

83

Risk Ratio (M‐H, Fixed, 95% CI)

0.45 [0.29, 0.71]

4.2 risperidone

1

183

Risk Ratio (M‐H, Fixed, 95% CI)

0.85 [0.60, 1.21]

5 Mental state: 1. General b. Various measures of change Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 less than 50% PANSS reduction (risperidone)

1

183

Risk Ratio (M‐H, Fixed, 95% CI)

0.85 [0.60, 1.21]

5.2 less than 40% PANSS reduction (olanzapine)

1

83

Risk Ratio (M‐H, Fixed, 95% CI)

0.45 [0.29, 0.71]

5.3 less than 50% BPRS reduction (risperidone)

1

183

Risk Ratio (M‐H, Fixed, 95% CI)

0.78 [0.55, 1.12]

6 Mental state: 1. General c. Average change (PANSS endpoint, low=poor) Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

6.1 olanzapine

1

82

Mean Difference (IV, Fixed, 95% CI)

‐11.2 [‐20.16, ‐2.24]

6.2 risperidone

1

182

Mean Difference (IV, Fixed, 95% CI)

‐1.60 [‐8.81, 5.61]

7 Mental state: 1. General d. Average change (BPRS endpoint, low=poor) Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

7.1 olanzapine

1

82

Mean Difference (IV, Fixed, 95% CI)

‐7.80 [‐13.35, ‐2.25]

7.2 risperidone

1

182

Mean Difference (IV, Fixed, 95% CI)

‐1.10 [‐5.27, 3.07]

8 Mental state: 2. Specific a. Positive symptoms ‐ average change (PANSS positive subscore endpoint, low=poor) Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

8.1 olanzapine

1

82

Mean Difference (IV, Fixed, 95% CI)

‐3.40 [‐6.34, ‐0.46]

8.2 risperidone

1

182

Mean Difference (IV, Fixed, 95% CI)

‐0.10 [‐2.18, 1.98]

9 Mental state: 2. Specific b. Positive symptoms ‐ average change (BPRS positive subscore endpoint, low=poor) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

9.1 olanzapine

1

82

Mean Difference (IV, Fixed, 95% CI)

‐1.30 [‐3.28, 0.68]

10 Mental state: 2. Specific c. Negative symptoms ‐ average change (PANSS negative subscore endpoint, low=poor) Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

10.1 olanzapine

1

82

Mean Difference (IV, Fixed, 95% CI)

‐2.7 [‐5.41, 0.01]

10.2 risperidone

1

182

Mean Difference (IV, Fixed, 95% CI)

‐0.5 [‐2.58, 1.58]

11 Mental state: 2. Specific d. Negative symptoms ‐ average change (BPRS negative subscore endpoint, low=poor) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

11.1 olanzapine

1

82

Mean Difference (IV, Fixed, 95% CI)

‐1.60 [‐3.10, ‐0.10]

12 Mental state: 2. Specific e. Depressive symptoms ‐ average change (MADRS endpoint, low=poor) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

12.1 olanzapine

1

66

Mean Difference (IV, Fixed, 95% CI)

‐2.90 [‐7.01, 1.21]

13 Adverse events: 1. General a. At least one adverse event Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

13.1 risperidone

1

183

Risk Ratio (M‐H, Fixed, 95% CI)

0.86 [0.76, 0.98]

14 Adverse events: 2. Extrapyramdial problems a. General i. Needing anticholinergic medication at least once Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

14.1 olanzapine

1

83

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.15, 0.72]

14.2 risperidone

1

183

Risk Ratio (M‐H, Fixed, 95% CI)

0.67 [0.53, 0.85]

15 Adverse events: 2. Extrapyramdial problems a. General ii. Not improved (SAS total >3) Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

15.1 olanzapine

1

83

Risk Ratio (M‐H, Fixed, 95% CI)

0.37 [0.17, 0.79]

16 Adverse events: 2. Extrapyramdial problems a. General iii. Average change (SAS, low=poor) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

16.1 olanzapine

1

83

Mean Difference (IV, Fixed, 95% CI)

‐5.0 [‐8.08, ‐1.92]

17 Adverse events: 2. Extrapyramdial problems b. Specific i. Akathisia Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

17.1 olanzapine

1

83

Risk Ratio (M‐H, Fixed, 95% CI)

0.17 [0.05, 0.62]

18 Adverse events: 2. Extrapyramdial problems b. Specific ii. Akathisia ‐ average change (BAS, low=poor) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

18.1 olanzapine

1

83

Mean Difference (IV, Fixed, 95% CI)

‐0.6 [‐1.12, ‐0.08]

19 Adverse Events: 2. Extrapyramdial problems b. Specific iii. Others Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

19.1 extrapyramidal syndrome ‐ olanzapine

1

83

Risk Ratio (M‐H, Fixed, 95% CI)

0.27 [0.05, 1.52]

19.2 hypertonia ‐ olanzapine

1

83

Risk Ratio (M‐H, Fixed, 95% CI)

0.29 [0.10, 0.83]

19.3 hypokinesia ‐ olanzapine

1

83

Risk Ratio (M‐H, Fixed, 95% CI)

0.05 [0.00, 0.83]

20 Adverse events: 3. Others Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

20.1 agitation ‐ risperidone

1

183

Risk Ratio (M‐H, Fixed, 95% CI)

0.75 [0.30, 1.87]

20.2 anxiety/nervousness ‐ risperidone

1

183

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.37, 2.56]

20.3 anxiety/nervousness ‐ olanzapine

1

83

Risk Ratio (M‐H, Fixed, 95% CI)

0.27 [0.05, 1.52]

20.4 asthenia ‐ olanzapine

1

83

Risk Ratio (M‐H, Fixed, 95% CI)

7.92 [0.48, 130.88]

20.5 dizzyness ‐ olanzapine

1

83

Risk Ratio (M‐H, Fixed, 95% CI)

2.44 [0.31, 19.21]

20.6 headache ‐ olanzapine

1

83

Risk Ratio (M‐H, Fixed, 95% CI)

7.92 [0.48, 130.88]

20.7 headache ‐ risperidone

1

183

Risk Ratio (M‐H, Fixed, 95% CI)

1.06 [0.44, 2.56]

20.8 insomnia ‐ olanzapine

1

83

Risk Ratio (M‐H, Fixed, 95% CI)

1.22 [0.36, 4.12]

20.9 insomnia ‐ risperidone

1

183

Risk Ratio (M‐H, Fixed, 95% CI)

0.65 [0.30, 1.41]

20.10 somnolence ‐ olanzapine

1

83

Risk Ratio (M‐H, Fixed, 95% CI)

9.58 [0.59, 156.45]

Figures and Tables -
Comparison 1. NEW GENERATION ANTIPSYCHOTICS versus CONVENTIONAL ANTIPSYCHOTICS (HALOPERIDOL)