Clinical relevance of findings in trials of antipsychotics: systematic review

Abstract

BackgroundThere is concern over the methods used to evaluate antipsychotic drugs.AimsTo assess the clinical relevance of findings in the literature.MethodA systematic review identified studies of antipsychotics that used the Brief Psychiatric Rating Scale (BPRS) and Positive and Negative Syndrome Scale (PANSS). A published method of translating these into Clinical Global Impression – Change scale (CGI–C) scores was used to measure clinical relevance.ResultsIn total 98 data-sets were included in the BPRS analysis and 202 data-sets in the PANSS analysis. When aggregated scores were translated into notional CGI–C scores, most drugs reached ‘minimal improvement’ on the BPRS, but few reached that level for PANSS. This was true of both first- and second-generation drugs, including clozapine. Amisulpride and olanzapine had better than average CGI–C scores.ConclusionsOur findings show improvements of limited clinical relevance. The CGI–C scores were better for the BPRS than for the PANSS.