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Atypical antipsychotics for psychosis in adolescents

  1. Ajit Kumar1,
  2. Soumitra S Datta2,3,*,
  3. Stephen D Wright4,
  4. Vivek A Furtado5,
  5. Paul S Russell6

Editorial Group: Cochrane Schizophrenia Group

Published Online: 15 OCT 2013

Assessed as up-to-date: 18 JUL 2012

DOI: 10.1002/14651858.CD009582.pub2


How to Cite

Kumar A, Datta SS, Wright SD, Furtado VA, Russell PS. Atypical antipsychotics for psychosis in adolescents. Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No.: CD009582. DOI: 10.1002/14651858.CD009582.pub2.

Author Information

  1. 1

    Leeds and York Partnership NHS Foundation Trust, Psychiatry, Leeds, UK

  2. 2

    Institute of Psychiatry, King's College London, Child & Adolescent Psychiatry, London, UK

  3. 3

    Tata Medical Centre, Department of Palliative Care & Psycho-oncology, Kolkata, West Bengal, India

  4. 4

    Leeds Partnerships NHS Foundation Trust, Central & North West Community Mental Health Team, Leeds, West Yorkshire, UK

  5. 5

    Institute of Mental Health, Forensic Psychiatry, Nottingham, Nottinghamshire, UK

  6. 6

    Christian Medical College, Child & Adolescent Psychiatry, Vellore, Tamil Nadu, India

*Soumitra S Datta, Child & Adolescent Psychiatry, Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, UK. ssdatta2000@yahoo.com. ssdatta@doctors.org.uk.

Publication History

  1. Publication Status: New
  2. Published Online: 15 OCT 2013

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[Figure 1]
Figure 1. Review flow diagram.
[Figure 2]
Figure 2. Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
[Analysis 1.1]
Analysis 1.1. Comparison 1 Atypical antipsychotics vs placebo (only short term), Outcome 1 Global state: No response (CGI-S).
[Analysis 1.2]
Analysis 1.2. Comparison 1 Atypical antipsychotics vs placebo (only short term), Outcome 2 Mental state: 1. No response.
[Analysis 1.3]
Analysis 1.3. Comparison 1 Atypical antipsychotics vs placebo (only short term), Outcome 3 Mental state: 2. Change in PANSS score (data skewed, high score = good).
[Analysis 1.4]
Analysis 1.4. Comparison 1 Atypical antipsychotics vs placebo (only short term), Outcome 4 Adverse effects: 1. Different adverse effects (binary measures).
[Analysis 1.5]
Analysis 1.5. Comparison 1 Atypical antipsychotics vs placebo (only short term), Outcome 5 Adverse effects: 2. Different adverse effects (continuous measures—mean changes).
[Analysis 1.6]
Analysis 1.6. Comparison 1 Atypical antipsychotics vs placebo (only short term), Outcome 6 Leaving study early: 1. Various reasons (olanzapine vs placebo).
[Analysis 1.7]
Analysis 1.7. Comparison 1 Atypical antipsychotics vs placebo (only short term), Outcome 7 Leaving study early: 2. Any reason (aripiprazole vs placebo).
[Analysis 1.8]
Analysis 1.8. Comparison 1 Atypical antipsychotics vs placebo (only short term), Outcome 8 Quality of life: 1. Mean end point PQ-LES-Q score at 6 weeks (data skewed, high score = good).
[Analysis 2.1]
Analysis 2.1. Comparison 2 Atypical vs typical antipsychotics (only short term), Outcome 1 Global state: 1. Worse or no improvement.
[Analysis 2.2]
Analysis 2.2. Comparison 2 Atypical vs typical antipsychotics (only short term), Outcome 2 Global state: 2a. Mean end point score (CGAS, high score = good).
[Analysis 2.3]
Analysis 2.3. Comparison 2 Atypical vs typical antipsychotics (only short term), Outcome 3 Global state: 2b. Mean end point score (CGI-I, high score = poor).
[Analysis 2.4]
Analysis 2.4. Comparison 2 Atypical vs typical antipsychotics (only short term), Outcome 4 Mental state: 1. No improvement (BPRS, high score = poor).
[Analysis 2.5]
Analysis 2.5. Comparison 2 Atypical vs typical antipsychotics (only short term), Outcome 5 Mental state: 2a. Mean end point scores (various scales, high score = poor).
[Analysis 2.6]
Analysis 2.6. Comparison 2 Atypical vs typical antipsychotics (only short term), Outcome 6 Mental state: 2b. Mean end point scores (high score = poor, skewed data).
[Analysis 2.7]
Analysis 2.7. Comparison 2 Atypical vs typical antipsychotics (only short term), Outcome 7 Adverse effects: 1. Anticholinergic adverse effects (TESS).
[Analysis 2.8]
Analysis 2.8. Comparison 2 Atypical vs typical antipsychotics (only short term), Outcome 8 Adverse effects: 2a. Extrapyramidal adverse effects (TESS).
[Analysis 2.9]
Analysis 2.9. Comparison 2 Atypical vs typical antipsychotics (only short term), Outcome 9 Adverse effects: 2b. Extrapyramidal adverse effects (mean end point scores).
[Analysis 2.10]
Analysis 2.10. Comparison 2 Atypical vs typical antipsychotics (only short term), Outcome 10 Adverse effects: 3a. Other significant adverse effects.
[Analysis 2.11]
Analysis 2.11. Comparison 2 Atypical vs typical antipsychotics (only short term), Outcome 11 Adverse effects: 3b. Other significant adverse effects (mean end point).
[Analysis 2.12]
Analysis 2.12. Comparison 2 Atypical vs typical antipsychotics (only short term), Outcome 12 Leaving study early: various reasons.
[Analysis 3.1]
Analysis 3.1. Comparison 3 Atypical antipsychotics vs atypical antipsychotics (only short term), Outcome 1 Global state: 1. No improvement or no response.
[Analysis 3.2]
Analysis 3.2. Comparison 3 Atypical antipsychotics vs atypical antipsychotics (only short term), Outcome 2 Global state: 2. Mean end point scores (high score = good).
[Analysis 3.3]
Analysis 3.3. Comparison 3 Atypical antipsychotics vs atypical antipsychotics (only short term), Outcome 3 Mental state: 1. No response.
[Analysis 3.4]
Analysis 3.4. Comparison 3 Atypical antipsychotics vs atypical antipsychotics (only short term), Outcome 4 Mental state: mean end point scores (various scales, high score = poor).
[Analysis 3.5]
Analysis 3.5. Comparison 3 Atypical antipsychotics vs atypical antipsychotics (only short term), Outcome 5 Mental state: mean end point score (BPRS, data skewed, high score = poor).
[Analysis 3.6]
Analysis 3.6. Comparison 3 Atypical antipsychotics vs atypical antipsychotics (only short term), Outcome 6 Adverse effects: 1a. Different adverse effects (clozapine vs olanzapine).
[Analysis 3.7]
Analysis 3.7. Comparison 3 Atypical antipsychotics vs atypical antipsychotics (only short term), Outcome 7 Adverse effects: 1b. i. Different adverse effects (risperidone vs olanzapine).
[Analysis 3.8]
Analysis 3.8. Comparison 3 Atypical antipsychotics vs atypical antipsychotics (only short term), Outcome 8 Adverse effects: 1b.ii. Different adverse effects—means at end of study (risperidone vs olanzapine, high score = poor).
[Analysis 3.9]
Analysis 3.9. Comparison 3 Atypical antipsychotics vs atypical antipsychotics (only short term), Outcome 9 Adverse effects: 1b.iii. Different adverse effects—mean change (risperidone vs olanzapine, data skewed, high score = poor).
[Analysis 3.10]
Analysis 3.10. Comparison 3 Atypical antipsychotics vs atypical antipsychotics (only short term), Outcome 10 Adverse effects: 1c. Different adverse effects (risperidone vs quetiapine).
[Analysis 3.11]
Analysis 3.11. Comparison 3 Atypical antipsychotics vs atypical antipsychotics (only short term), Outcome 11 Adverse effects: 2a. Metabolic syndrome measures—means at end of study (clozapine vs olanzapine).
[Analysis 3.12]
Analysis 3.12. Comparison 3 Atypical antipsychotics vs atypical antipsychotics (only short term), Outcome 12 Adverse effects: 2b.i. Metabolic syndrome measures—means at end of study (risperidone vs olanzapine).
[Analysis 3.13]
Analysis 3.13. Comparison 3 Atypical antipsychotics vs atypical antipsychotics (only short term), Outcome 13 Adverse effects: 2b. ii. Metabolic syndrome measures—mean changes (risperidone vs olanzapine, data skewed, high score = poor).
[Analysis 3.14]
Analysis 3.14. Comparison 3 Atypical antipsychotics vs atypical antipsychotics (only short term), Outcome 14 Leaving study early: 1a. Clozapine vs olanzapine.
[Analysis 3.15]
Analysis 3.15. Comparison 3 Atypical antipsychotics vs atypical antipsychotics (only short term), Outcome 15 Leaving the study early: 1b. Olanzapine vs quetiapine.
[Analysis 3.16]
Analysis 3.16. Comparison 3 Atypical antipsychotics vs atypical antipsychotics (only short term), Outcome 16 Leaving study early: 1c. Risperidone vs olanzapine.
[Analysis 3.17]
Analysis 3.17. Comparison 3 Atypical antipsychotics vs atypical antipsychotics (only short term), Outcome 17 Leaving the study early: 1d. Risperidone vs quetiapine.
[Analysis 4.1]
Analysis 4.1. Comparison 4 Atypical (standard dose) vs atypical (low dose) antipsychotics (only short term), Outcome 1 Global state: 1. No response—not sustained response at end of 8 weeks.
[Analysis 4.2]
Analysis 4.2. Comparison 4 Atypical (standard dose) vs atypical (low dose) antipsychotics (only short term), Outcome 2 Global state: 2a. Mean end point score (CGI-I, high score = poor).
[Analysis 4.3]
Analysis 4.3. Comparison 4 Atypical (standard dose) vs atypical (low dose) antipsychotics (only short term), Outcome 3 Global state: 2b. Mean scores—at 6 weeks (aripiprazole 30 mg vs 10 mg).
[Analysis 4.4]
Analysis 4.4. Comparison 4 Atypical (standard dose) vs atypical (low dose) antipsychotics (only short term), Outcome 4 Mental state: 1. No response.
[Analysis 4.5]
Analysis 4.5. Comparison 4 Atypical (standard dose) vs atypical (low dose) antipsychotics (only short term), Outcome 5 Mental state: 2. Mean end point scores (high score = poor).
[Analysis 4.6]
Analysis 4.6. Comparison 4 Atypical (standard dose) vs atypical (low dose) antipsychotics (only short term), Outcome 6 Adverse effects: 1. Endrocrine.
[Analysis 4.7]
Analysis 4.7. Comparison 4 Atypical (standard dose) vs atypical (low dose) antipsychotics (only short term), Outcome 7 Adverse effects: 2. Extrapyramidal.
[Analysis 4.8]
Analysis 4.8. Comparison 4 Atypical (standard dose) vs atypical (low dose) antipsychotics (only short term), Outcome 8 Adverse effects: 3. Metabolic.
[Analysis 4.9]
Analysis 4.9. Comparison 4 Atypical (standard dose) vs atypical (low dose) antipsychotics (only short term), Outcome 9 Adverse effects: 4. Others.
[Analysis 4.10]
Analysis 4.10. Comparison 4 Atypical (standard dose) vs atypical (low dose) antipsychotics (only short term), Outcome 10 Adverse effects: 5. Others (particular to the aripiprazole 30 mg vs 10 mg comparison).
[Analysis 4.11]
Analysis 4.11. Comparison 4 Atypical (standard dose) vs atypical (low dose) antipsychotics (only short term), Outcome 11 Adverse effects: 6. Laboratory tests (particular to the aripiprazole 30 mg vs 10 mg comparison).
[Analysis 4.12]
Analysis 4.12. Comparison 4 Atypical (standard dose) vs atypical (low dose) antipsychotics (only short term), Outcome 12 Leaving study early: 1. Various reasons.
[Analysis 4.13]
Analysis 4.13. Comparison 4 Atypical (standard dose) vs atypical (low dose) antipsychotics (only short term), Outcome 13 Leaving study early: 2. Ziprasidone 160 mg vs 80 mg.
[Analysis 4.14]
Analysis 4.14. Comparison 4 Atypical (standard dose) vs atypical (low dose) antipsychotics (only short term), Outcome 14 Leaving study early: 3. Aripiprazole 30 mg vs aripiprazole 10 mg.
[Analysis 4.15]
Analysis 4.15. Comparison 4 Atypical (standard dose) vs atypical (low dose) antipsychotics (only short term), Outcome 15 Quality of life: mean end point score—at 6 weeks (PQ-LES-Q, aripiprazole 30 mg vs aripiprazole 10 mg, data skewed, high score = good).