Clinical relevance of findings in trials of antipsychotics: systematic review

Abstract

There is concern over the methods used to evaluate antipsychotic drugs. To assess the clinical relevance of findings in the literature. A 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. In 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. Our findings show improvements of limited clinical relevance. The CGI-C scores were better for the BPRS than for the PANSS.