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Original ArticleOpen Access
Comparison of the Efficacy and Acceptability of Atypical Antipsychotic Drugs: a Meta-Analysis of Randomized, Placebo-Controlled Trials
Srisurapanont M 
,
Maneeton N
,
Maneeton N Knowing the clinical differences of olanzapine, quetiapine, and risperidone would be of
benefit for choosing an atypical antipsychotic drug. In order to compare their efficacy and acceptability,
we conducted a meta-analysis of published, randomized, placebo-controlled trials by
comparing the response and dropout rates of an atypical antipsychotic drug group and those of a
placebo group. After a comprehensive search of study reports, the response and dropout rates of
patients treated with an atypical antipsychotic drug and those treated with placebo were extracted
on the intention-to-treat basis. The effect size with 95 per cent confidence interval (CI) of pooled
data comparing the response and dropout rates of an atypical antipsychotic drug group and those
of a placebo group were calculated by using the Peto method. The response-rate effect sizes
(95% CIs) of olanzapine, quetiapine, and risperidone were 1.75 (1.06 to 2.89), 1.71 (1.20 to 2.42).
and 3.28 (1.98 to 5.44), respectively. The dropout-rate effect sizes (95% Cis) of olanzapine,
quetiapine, and risperidone were 0.55 (0.35 to 0.88), 0.65 (0.46 to 0.91 ), and 0.39 (0.24 to 0.62),
respectively. In conclusion, olanzapine, quetiapine, and risperidone are more effective and more
acceptable than placebo in treating schizophrenic patients. However, they are not different from
each other in the respect of efficacy and acceptability. The cost of these agents should play an
important role in choosing an atypical antipsychotic drug.
Key word : Antipsychotic Drugs, Olanzapine, Quetiapine, Risperidone, Randomized-Controlled Trial, Meta-Analysis
benefit for choosing an atypical antipsychotic drug. In order to compare their efficacy and acceptability,
we conducted a meta-analysis of published, randomized, placebo-controlled trials by
comparing the response and dropout rates of an atypical antipsychotic drug group and those of a
placebo group. After a comprehensive search of study reports, the response and dropout rates of
patients treated with an atypical antipsychotic drug and those treated with placebo were extracted
on the intention-to-treat basis. The effect size with 95 per cent confidence interval (CI) of pooled
data comparing the response and dropout rates of an atypical antipsychotic drug group and those
of a placebo group were calculated by using the Peto method. The response-rate effect sizes
(95% CIs) of olanzapine, quetiapine, and risperidone were 1.75 (1.06 to 2.89), 1.71 (1.20 to 2.42).
and 3.28 (1.98 to 5.44), respectively. The dropout-rate effect sizes (95% Cis) of olanzapine,
quetiapine, and risperidone were 0.55 (0.35 to 0.88), 0.65 (0.46 to 0.91 ), and 0.39 (0.24 to 0.62),
respectively. In conclusion, olanzapine, quetiapine, and risperidone are more effective and more
acceptable than placebo in treating schizophrenic patients. However, they are not different from
each other in the respect of efficacy and acceptability. The cost of these agents should play an
important role in choosing an atypical antipsychotic drug.
Key word : Antipsychotic Drugs, Olanzapine, Quetiapine, Risperidone, Randomized-Controlled Trial, Meta-Analysis
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