A Cochrane review [Abstract] 1 included 3 studies on antipsychotic medication for treatment of schizophrenia in people over 65 years of age, with a total of 252 subjects. One small study (n=18) compared thioridazine with remoxipride (RR leaving the study early 1.0 CI 0.07 to 13.6). A second study (n=175) compared risperidone with olanzapine. Global state 'not improved/worse' was not significantly different between treatments (n= 171, RR 1.26 CI 0.8 to 1.9); mental state PANSS total endpoint scores were also equivocal (n=171, RR 0.98 CI 0.76 to 1.26) as were all cognitive function tests. The third study (subset n=59) compared olanzapine with haloperidol and mental state change scores (BPRS WMD -3.60 CI -10.8 to 3.6; PANSS WMD -6.00 CI -18.3 to 6.3) were equivocal. It was not possible to extract usable data on quality of life, satisfaction, service use, or economic outcomes.
Comment: The quality of evidence is downgraded by study quality (e.g. more than 20% loss to follow up), by indirectness (differences in studied patients, drawn from different care settings, and in the reported outcomes) and by inconsistency (variability in results across studies).
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