A Cochrane review [Abstract] 1 included 6 studies with a total of 256 subjects (children and adolescents). All studies were short term (less than 12 weeks). Typical (haloperidol, chlorpromazine, fluphenazine) and atypical (clozapine, risperidone, olanzapine) antipsychotic drugs in a wide range of doses were administered in the studies. In the only study (n=21) to report any differences between treatment groups, a few results favoured the atypical antipsychotic clozapine over haloperidol in treatment resistant childhood-onset schizophrenia (WMD CGAS (The Childrens Global Assessment Scale) 17.00, 95% CI 7.74 to 26.26; WMD Bunney-Hamburg Psychosis Rating Scale -3.60, 95% CI -6.64 to -0.56). Participants on clozapine, however, were three times more likely to have drowsiness (RR 3.30, 95% CI 1.23 to 8.85, NNH 2, 95% CI 2 to 17) and half of the children receiving clozapine had neutropenia (RR 12, 95% CI 0.75 to192.86). There were no other studies comparing clozapine with haloperidol or with other typical antipsychotic drugs.
Comment: The quality of evidence is downgraded by indirectness (short study duration) and by imprecise results (few patients).
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