Comparative Efficacy and Safety of Atypical and Conventional Antipsychotic Drugs in First-Episode Psychosis: A Randomized, Double-Blind Trial of Olanzapine Versus Haloperidol

作者：Jeffrey A. Lieberman, Gary D. Tollefson, Mauricio Tohen, Alan I. Green, Raquel E. Gur, René S. Kahn, Joseph P. McEvoy, Diana O. Perkins, Tonmoy Sharma, Robert B. Zipursky, Hank Wei, Robert M. Hamer, the HGDH Study Group · 发表于：American Journal of Psychiatry · 年份：2003 · DOI：10.1176/appi.ajp.160.8.1396 · 被引用次数：407 · 研究领域：Schizophrenia research and treatment、Neurotransmitter Receptor Influence on Behavior、Parkinson's Disease Mechanisms and Treatments

OBJECTIVE: Few long-term studies have compared the efficacy and safety of typical and atypical antipsychotic medications directly in patients with a first episode of psychosis who met the criteria for schizophrenia or a related psychotic disorder. This study compared the acute and long-term effectiveness of haloperidol with that of olanzapine in patients with first-episode psychosis in a large, controlled clinical trial. METHOD: Patients with first-episode psychosis (N=263) were randomly assigned under double-blind conditions to receive haloperidol or olanzapine and were followed for up to 104 weeks. Domains measured included psychopathology, psychosocial variables, neurocognitive functioning, and brain morphology and metabolism. This report presents data from clinical measures of treatment response and safety data from the 12-week acute treatment phase. RESULTS: Haloperidol and olanzapine were associated with substantial and comparable baseline-to-endpoint reductions in symptom severity, which did not differ significantly in last-observation-carried-forward analyses. However, in a mixed-model analysis, olanzapine-treated subjects had significantly greater decreases in symptom severity as measured by the Positive and Negative Syndrome Scale total score and negative and general scales and by the Montgomery-Asberg Depression Rating Scale but not as measured by the Positive and Negative Syndrome Scale positive scale and by the Clinical Global Impression severity rating. Olanzapi...