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Drug treatments for constipation caused by antipsychotic medications

Constipation is a common side effect for people taking antipsychotic medications, especially clozapine. It has been shown that clozapine reduces bowel motility, and the consequences of this are sometimes serious. For every thousand patients treated with clozapine, it is thought that 300 to 600 will suffer constipation; at least four will develop serious gastrointestinal complications (such as bowel obstruction), from which at least one will die.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Atypical antipsychotics for people with both schizophrenia and depression

It is well known that depression occurs in people with schizophrenia. Atypical antipsychotics are used to treat the symptoms of schizophrenia but their specific effects on those with schizophrenia and depression are unclear, although they are marketed for this purpose.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Aripiprazole versus other atypical antipsychotics

In many countries in the industrialised world there has been a huge growth in the prescription of medication for people with mental health problems, taken orally as a tablet or by injection. Atypical and second generation antipsychotic drugs have become ever more popular, because they are thought to help people with mental health problems who do not respond quite so well to initial treatment. These newer drugs hold the promise of both reducing symptoms, such as hearing voices or seeing things, and reducing problematic side effects, such as sleepiness, weight gain, and shaking.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Sertindole versus other atypical antipsychotics for schizophrenia

The data from these trials are limited and a considerable number of the participants left the study early. In addition, sertindole has only been compared to one second generation antipsychotic and the trials are relatively short. A larger and longer trial comparing sertindole to other second generation antipsychotics, with the outcomes including mental state, general functioning, adverse effects and quality of life, would enhance our knowledge in this area considerably.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Levomepromazine for schizophrenia

Schizophrenia is a profoundly disabling mental illness affecting thoughts, emotions and behaviour. It has a life time prevalence of about 1%. Antipsychotic medications still remain as the mainstay of treatment for schizophrenia. Antipsychotic medications are classified into typical and atypical subtypes. First generation or typical antipsychotic medications have been the mainstay of treatment for schizophrenia for decades and have been effective in reducing the positive symptoms of schizophrenia, but negative symptoms have been fairly resistant to treatment. With the advent of atypical antipsychotics there has been a surge in prescriptions of the atypical antipsychotic medications in recent years. Levomepromazine is one among these 'older' typical antipsychotic medications. We systematically reviewed the effects of levomepromazine in comparison to other typical and atypical antipsychotic medications for people with schizophrenia and schizophrenia‐like disorders. We were able to include four studies in our systematic review.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Atypical antipsychotic medications for adolescents with psychosis

This plain language summary has been written by Benjamin Gray, Service User and Service User Expert, Rethink Mental Illness (Email: ben.gray@rethink.org).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Atypical antipsychotics benefit people with dementia but the risks of adverse events may outweigh the benefits, particularly with long term treatment

Atypical antipsychotics have become the pharmacological treatment of choice for many clinicians in the treatment of behavioural and psychiatric symptoms in people with dementia, and the largest evidence base for double blind placebo controlled trials in this area is for risperidone. Particularly in view of recent safety concerns, a meta‐analysis of efficacy and adverse events to inform clinical practice is timely. Modest efficacy is evident, but the elevated risk of cerebrovascular adverse events, mortality, upper respiratory infections, oedema and extrapyramidal symptoms is a concern, particularly as selective reporting makes interpretation of other potential adverse outcomes impossible.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Amisulpride versus other atypical antipsychotics for schizophrenia

This review compared the effects of amisulpride with those of other so called second generation (atypical) antipsychotic drugs. For half of the possible comparisons not a single relevant study could be identified. Based on very limited data there was no difference in efficacy comparing amisulpride with olanzapine and risperidone, but a certain advantage compared with ziprasidone. Amisulpride was associated with less weight gain than risperidone and olanzapine.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

New generation antipsychotics for first episode schizophrenia

A new generation of antipsychotics, drugs such as olanzapine and risperidone are recommended for people with a first episode of schizophrenia. Currently, the quality of information is too limited to come to any firm conclusions. A number of ongoing studies should provide more and better information in the near future.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Olanzapine for schizophrenia

Since the early 1950s the mainstay of treatment for schizophrenia has been the typical antipsychotics such as chlorpromazine and haloperidol. Although they are effective in controlling voices and delusions for many people with schizophrenia, they have a smaller effect on symptoms such as apathy and social withdrawal. They also have disabling adverse effects such as tremor, stiffness and slowing of movement. The newer drugs, such as olanzapine, are reputed to have fewer adverse motor effects and are as effective, if not more so, than the older drugs. This review examines the randomised controlled trials of olanzapine compared with placebo, typical and atypical antipsychotic drugs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Risperidone versus placebo for schizophrenia

People with schizophrenia often hear voices and see things (hallucinations) and have strange beliefs (delusions). These are called ‘positive symptoms’. Mental illness also causes tiredness, apathy, emotional numbness, and withdrawal. These are called ‘negative symptoms’. The main treatment for the symptoms of schizophrenia are antipsychotic drugs. Antipsychotic drugs can be classified into typical (older) and atypical (newer) drugs. Typical antipsychotics such as chlorpromazine and haloperidol have been the mainstay of treatment for decades, and have been effective in reducing the positive symptoms of schizophrenia. Negative symptoms, however, have been fairly resistant to treatment. In addition, drug treatments are associated with unpleasant side effects that cause people to stop taking medication, which may lead to relapse. It is thought that newer atypical antipsychotics, such as risperidone, are more effective than the older antipsychotics as they reduce the positive symptoms but cause fewer side effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Withdrawal of chronic antipsychotic drugs for behavioural and psychological symptoms in older people with dementia

People with dementia often have behavioural problems that can be difficult for carers to manage. Antipsychotic drugs are often prescribed to control symptoms and assist with controlling difficult behaviour. Many people with dementia continue to take these drugs over long periods of time. This review investigates whether withdrawal of long‐term antipsychotic treatment is feasible in older people with dementia suffering from behavioural symptoms (often called neuropsychiatric symptoms or NPS). These include agitation, aggression, hallucinations, anxiety, apathy, depression, delusions (beliefs that cannot be true), wandering, repeating of words or sounds, and shouting. Nine studies with 606 participants provided data for the review. Most of the participants were residents in nursing homes, but some were outpatients. The studies differed considerably in participants, methods and outcomes so that is was not possible to combine most of the data numerically.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Systematic Reviews in PubMed

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Systematic Review Methods in PubMed

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