Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Breier, A. F. Articles by Pickar, D. Search for Related Content PubMed Citation Articles by Breier, A. F. Articles by Pickar, D. Neuroendocrinology Schizophrenia Spectrum Disorders Other Neuroleptics

Clozapine and Risperidone in Chronic Schizophrenia: Effects on Symptoms, Parkinsonian Side Effects, and Neuroendocrine Response

OBJECTIVE: Clozapine and risperidone were the first two "second-generation" antipsychotic drugs approved for schizophrenia. There is currently little information about their comparative efficacy from head-to-head clinical trials. The purpose of this study was to examine the comparative efficacy of clozapine and risperidone for positive and negative symptoms, depression, parkinsonian side effects, and indexes of neuroendocrine function in schizophrenic patients who met a priori criteria for partial response to traditional neuroleptic agents. METHOD: After a baseline fluphenazine treatment period, 29 patients participated in a 6-week, double-blind, parallel-group comparison of the effects of these agents. RESULTS: Clozapine was superior to risperidone for positive symptoms and parkinsonian side effects, but there were no significant differences between the drugs on two measures of negative symptoms, Brief Psychiatric Rating Scale total scores, and depression scores. The clozapine patients, but not the risperidone patients, demonstrated significant reductions from the fluphenazine baseline in positive symptoms, total symptoms, and depression. In addition, clozapine produced fewer effects on plasma prolactin than risperidone or fluphenazine. The mean daily doses during week 6 of the trial were 403.6 mg of clozapine and 5.9 mg of risperidone. CONCLUSIONS: The findings from this study indicate that these drugs have both important differences and similarities in their comparative efficacy in chronically ill, partially responsive patients with schizophrenia. Further research on second-generation antipsychotic drugs in this patient population that addresses key methodological issues, such as optimal dose and treatment duration, are needed.

This article has been cited by other articles:

				S. M Smith The impact of hyperprolactinaemia on sexual function in patients with psychosis J Psychopharmacol, March 1, 2008; 22(2_suppl): 63 - 69. [Abstract] [PDF]

				J. M. Noel ASHP Therapeutic Position Statement on the Use of Second-Generation Antipsychotic Medications in the Treatment of Adults with Psychotic Disorders Am. J. Health Syst. Pharm., April 15, 2007; 64(8): 863 - 876. [Full Text] [PDF]

				S. Heres, J. Davis, K. Maino, E. Jetzinger, W. Kissling, and S. Leucht Why Olanzapine Beats Risperidone, Risperidone Beats Quetiapine, and Quetiapine Beats Olanzapine: An Exploratory Analysis of Head-to-Head Comparison Studies of Second-Generation Antipsychotics Am J Psychiatry, February 1, 2006; 163(2): 185 - 194. [Abstract] [Full Text] [PDF]

				M. E. Molitch Medication-Induced Hyperprolactinemia Mayo Clin. Proc., August 1, 2005; 80(8): 1050 - 1057. [Abstract] [PDF]

				J. Volavka, P. Czobor, B. Sheitman, J.-P. Lindenmayer, L. Citrome, J. P. McEvoy, T. B. Cooper, M. Chakos, and J. A. Lieberman Clozapine, Olanzapine, Risperidone, and Haloperidol in the Treatment of Patients With Chronic Schizophrenia and Schizoaffective Disorder Focus, January 1, 2004; 2(1): 59 - 67. [Abstract] [Full Text] [PDF]

				M. Chakos, J. Lieberman, E. Hoffman, D. Bradford, and B. Sheitman Effectiveness of Second-Generation Antipsychotics in Patients With Treatment-Resistant Schizophrenia: A Review and Meta-Analysis of Randomized Trials Focus, January 1, 2004; 2(1): 111 - 121. [Abstract] [Full Text] [PDF]

				J. M. Davis, N. Chen, and I. D. Glick A Meta-analysis of the Efficacy of Second-Generation Antipsychotics Arch Gen Psychiatry, June 1, 2003; 60(6): 553 - 564. [Abstract] [Full Text] [PDF]

				A. WIECK and P. M. HADDAD Antipsychotic-induced hyperprolactinaemia in women: pathophysiology, severity and consequences: Selective literature review The British Journal of Psychiatry, March 1, 2003; 182(3): 199 - 204. [Abstract] [Full Text] [PDF]

				A. H. FRIEDLANDER and S. R. MARDER The psychopathology, medical management and dental implications of schizophrenia J Am Dent Assoc, May 1, 2002; 133(5): 603 - 610. [Abstract] [Full Text] [PDF]

				J. Volavka, P. Czobor, B. Sheitman, J.-P. Lindenmayer, L. Citrome, J. P. McEvoy, T. B. Cooper, M. Chakos, and J. A. Lieberman Clozapine, Olanzapine, Risperidone, and Haloperidol in the Treatment of Patients With Chronic Schizophrenia and Schizoaffective Disorder Am J Psychiatry, February 1, 2002; 159(2): 255 - 262. [Abstract] [Full Text] [PDF]

				J.-M. Azorin, R. Spiegel, G. Remington, J.-M. Vanelle, J.-J. Pere, M. Giguere, and I. Bourdeix A Double-Blind Comparative Study of Clozapine and Risperidone in the Management of Severe Chronic Schizophrenia Am J Psychiatry, August 1, 2001; 158(8): 1305 - 1313. [Abstract] [Full Text] [PDF]

				M. Chakos, J. Lieberman, E. Hoffman, D. Bradford, and B. Sheitman Effectiveness of Second-Generation Antipsychotics in Patients With Treatment-Resistant Schizophrenia: A Review and Meta-Analysis of Randomized Trials Am J Psychiatry, April 1, 2001; 158(4): 518 - 526. [Abstract] [Full Text]

				T. Ellis, M. E. Cudkowicz, P. M. Sexton, and J. H. Growdon Clozapine and Risperidone Treatment of Psychosis in Parkinson's Disease J Neuropsychiatry Clin Neurosci, August 1, 2000; 12(3): 364 - 369. [Abstract] [Full Text]

				D. M. Taylor, D. M. Taylor, and D. Duncan-McConnell Refractory schizophrenia and atypical antipsychotics J Psychopharmacol, July 1, 2000; 14(4): 409 - 418. [Abstract] [PDF]

				R. M. HAMER and P. M. SIMPSON Comparison of Clozapine and Risperidone Am J Psychiatry, February 1, 2000; 157(2): 310 - 310. [Full Text]

Get information about faster international access.

Privacy Policy

Copyright © 1999 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us