Balancing body and mind: selecting the optimal antipsychotic

Abstract

In The Lancet, Maximilian Huhn and colleagues5 report a network meta-analysis of antipsychotic medications for the acute management of schizophrenia that includes 402 studies of 32 different antipsychotics with data for 53 463 participants (mean age 37·40 years [SD 5·96], 29 949 [56·02%] male and 23 514 [43·98%] female, mean illness duration 11·90 years [SD 5·19]). This is the largest and most comprehensive meta-analysis of antipsychotic medication for acute psychosis to date. The use of a network meta-analysis allows comparisons between agents that might not have been directly compared in clinical trials. Other strengths include consideration of the placebo response rate, study sample size, publication year, baseline severity, sponsorship, comparability of doses, and patient demographics, using both meta-regression and sensitivity analyses of excluding poorer-quality studies. None of these factors greatly altered outcomes.