{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T13:24:24Z","timestamp":1790515464678,"version":"4.1.0"},"reference-count":93,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T00:00:00Z","timestamp":1557100800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["World Psychiatry"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:p>Second\u2010generation antipsychotics (SGAs) are recommended for maintenance treatment in schizophrenia. However, comparative long\u2010term effectiveness among SGAs is unclear. Here we provide a systematic review and meta\u2010analysis of randomized trials lasting \u2265\u20d26 months comparing SGAs head\u2010to\u2010head in schizophrenia and related disorders. The primary outcome was all\u2010cause discontinuation. Secondary outcomes included efficacy and tolerability, i.e., psychopathology, inefficacy\u2010related and intolerability\u2010related discontinuation, relapse, hospitalization, remission, functioning, quality of life, and adverse events. Pooled risk ratio and standardized mean difference were calculated using random\u2010effects models. Across 59 studies (N=45,787), lasting 47.4\u00b132.1 weeks (range 24\u2010186), no consistent superiority of any SGA emerged across efficacy and tolerability outcomes. Regarding all\u2010cause discontinuation, clozapine, olanzapine and risperidone were significantly (p&lt;0.05) superior to several other SGAs, while quetiapine was inferior to several other SGAs. As to psychopathology, clozapine and olanzapine were superior to several other SGAs, while quetiapine and ziprasidone were inferior to several other SGAs. Data for other efficacy outcomes were sparse. Regarding intolerability\u2010related discontinuation, risperidone was superior and clozapine was inferior to several other SGAs. Concerning weight gain, olanzapine was worse than all other compared non\u2010clozapine SGAs, and risperidone was significantly worse than several other SGAs. As to prolactin increase, risperidone and amisulpride were significantly worse than several other SGAs. Regarding parkinsonism, olanzapine was superior to risperidone, without significant differences pertaining to akathisia. Concerning sedation and somnolence, clozapine and quetiapine were significantly worse than some other SGAs. In summary, different long\u2010term SGA efficacy and tolerability patterns emerged. The long\u2010term risk\u2010benefit profiles of specific SGAs need to be tailored to individual patients to optimize maintenance treatment outcomes.<\/jats:p>","DOI":"10.1002\/wps.20632","type":"journal-article","created":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T22:17:15Z","timestamp":1557181035000},"page":"208-224","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":117,"title":["Long\u2010term effectiveness of oral second\u2010generation antipsychotics in patients with schizophrenia and related disorders: a systematic review and meta\u2010analysis of direct head\u2010to\u2010head comparisons"],"prefix":"10.1002","volume":"18","author":[{"given":"Taishiro","family":"Kishimoto","sequence":"first","affiliation":[{"name":"Keio University School of Medicine Tokyo Japan"},{"name":"Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks New York NY USA"},{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Hempstead New York NY USA"},{"name":"Feinstein Institute for Medical Research, Manhasset New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuhiko","family":"Hagi","sequence":"additional","affiliation":[{"name":"Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks New York NY USA"},{"name":"Sumitomo Dainippon Pharma Co., Ltd. Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Nitta","sequence":"additional","affiliation":[{"name":"Sumitomo Dainippon Pharma Co., Ltd. Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Kane","sequence":"additional","affiliation":[{"name":"Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks New York NY USA"},{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Hempstead New York NY USA"},{"name":"Feinstein Institute for Medical Research, Manhasset New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph U.","family":"Correll","sequence":"additional","affiliation":[{"name":"Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks New York NY USA"},{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Hempstead New York NY USA"},{"name":"Feinstein Institute for Medical Research, Manhasset New York NY USA"},{"name":"Department of Child and Adolescent Psychiatry Charit\u00e9 Universit\u00e4tsmedizin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2015.67"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60239-6"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/mp.2011.143"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.56.3.241"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.160.7.1209"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.mp.4002136"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.11r06927"},{"key":"e_1_2_6_9_1","volume-title":"Cochrane handbook for systematic reviews of interventions, version 5.1.0","author":"Higgins JPT","year":"2011"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61032-6"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2011.156"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60733-3"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.13r08440"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbx090"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.epirev.a036084"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(95)00134-4"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.2000.10473905"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/070674370905400108"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.4321\/S0213-61632012000400004"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.jcp.0000222513.63767.de"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2006.05.010"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.162.10.1879"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.09m05155yel"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-006-0564-3"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/YIC.0b013e32835281ef"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-013-3241-3"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-011-2392-3"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-011-0220-8"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2010.111"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.2147\/TCRM.S3153"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S130211"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2008.07.033"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60486-9"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.08m04421"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2005.07.038"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-006-0428-x"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.jcp.0000236658.16286.25"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.jcp.0000204137.82298.06"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S121588"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5545.192016"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2006.00887.x"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa051688"},{"key":"e_1_2_6_47_1","first-page":"88","article-title":"Randomized controlled trial comparing changes in serum prolactin and weight among female patients with first\u2010episode schizophrenia over 12 months of treatment with risperidone or quetiapine","volume":"26","author":"Liu J","year":"2014","journal-title":"Shanghai Arch Psychiatry"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2013.03.013"},{"key":"e_1_2_6_49_1","unstructured":"A phase 3 randomized double\u2010blind active comparator\u2010controlled clinical trial to study the safety and efficacy of lurasidone in subjects with schizophrenia (PEARL 3 Extension Study). ClinicalTrials.govidentifier NCT00789698."},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.2006.163.4.600"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.2007.164.7.1050"},{"issue":"18","key":"e_1_2_6_52_1","first-page":"47","article-title":"A comparison of weight change during treatment with olanzapine or aripiprazole: results from a randomized, double\u2010blind study","volume":"65","author":"McQuade RD","year":"2004","journal-title":"J Clin Psychiatry"},{"key":"e_1_2_6_53_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.60.1.82"},{"key":"e_1_2_6_54_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v69n0214"},{"key":"e_1_2_6_55_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004850-200403000-00002"},{"key":"e_1_2_6_56_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2004.00486.x"},{"key":"e_1_2_6_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2013.07.006"},{"key":"e_1_2_6_58_1","unstructured":"A one\u2010year randomized prospective parallel open comparison of subjective well\u2010being in schizophrenic out\u2010patients treated with quetiapine XR (SEROQUEL XR\u2122) or oral risperidone at flexible dose in a naturalistic setting. ClinicalTrials.govidentifier NCT00600756."},{"key":"e_1_2_6_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30060-0"},{"key":"e_1_2_6_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2017.09.008"},{"key":"e_1_2_6_61_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.12468"},{"key":"e_1_2_6_62_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.57.3.249"},{"key":"e_1_2_6_63_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.2354"},{"key":"e_1_2_6_64_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2013.07.003"},{"key":"e_1_2_6_65_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1521-0391.2014.12126.x"},{"key":"e_1_2_6_66_1","first-page":"196","article-title":"Long\u2010term efficacy and safety of asenapine or olanzapine in patients with schizophrenia or schizoaffective disorder: an extension study","volume":"45","author":"Schoemaker J","year":"2012","journal-title":"Pharmacopsychiatry"},{"key":"e_1_2_6_67_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.13m08351"},{"key":"e_1_2_6_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0893-133X(02)00375-5"},{"key":"e_1_2_6_69_1","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0b013e31825cccad"},{"key":"e_1_2_6_70_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.162.8.1535"},{"key":"e_1_2_6_71_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2010.08040484"},{"key":"e_1_2_6_72_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.2006.163.4.611"},{"key":"e_1_2_6_73_1","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1176\/ajp.2007.164.3.415","article-title":"Effectiveness of olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia after discontinuing perphenazine: a CATIE study","volume":"164","author":"Stroup TS","year":"2007","journal-title":"Am J Psychiatry"},{"key":"e_1_2_6_74_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2010.01563.x"},{"key":"e_1_2_6_75_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004714-199710000-00010"},{"key":"e_1_2_6_76_1","doi-asserted-by":"publisher","DOI":"10.1185\/030079907X162665"},{"key":"e_1_2_6_77_1","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S80925"},{"key":"e_1_2_6_78_1","doi-asserted-by":"publisher","DOI":"10.1002\/hup.2270"},{"key":"e_1_2_6_79_1","unstructured":"A multicenter double\u2010blind flexible\u2010dose 6\u2010month trial comparing the efficacy and safety of asenapine with olanzapine in stable subjects with predominant persistent negative symptoms of schizophrenia. ClinicalTrials.govidentifier NCT00145496."},{"key":"e_1_2_6_80_1","unstructured":"A multicenter open label flexible\u2010dose parallel\u2010group evaluation of the cataractogenic potential of quetiapine fumarate (Seroquel) and risperidone (Risperdal) in the long term treatment of participants with schizophrenia or schizoaffective disorder. ClinicalTrials.govidentifier NCT00206102."},{"key":"e_1_2_6_81_1","unstructured":"Efficacy and safety of asenapine compared with olanzapine in patients with persistent negative symptoms of schizophrenia (25543) (P05817). ClinicalTrials.govidentifier NCT00212836."},{"key":"e_1_2_6_82_1","unstructured":"A six\u2010month double\u2010blind randomized international multicenter trial to evaluate the glucoregulatory effects of risperidone and olanzapine in subjects with schizophrenia or schizoaffective disorder. ClinicalTrials.govidentifier NCT00236379."},{"key":"e_1_2_6_83_1","unstructured":"Clozapine vs. risperidone for people with first episode schizophrenia and co\u2010occurring substance use disorder. ClinicalTrials.govidentifier NCT00573287."},{"key":"e_1_2_6_84_1","unstructured":"Comparison of Optimal Antipsychotic Treatments for Adults With Schizophrenia (COATS). ClinicalTrials.govidentifier NCT00802100."},{"key":"e_1_2_6_85_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.162.3.441"},{"key":"e_1_2_6_86_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjpo.bp.115.002576"},{"key":"e_1_2_6_87_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.10r06264yel"},{"key":"e_1_2_6_88_1","doi-asserted-by":"publisher","DOI":"10.31887\/DCNS.2014.16.4\/mcarbon"},{"key":"e_1_2_6_89_1","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2010.78"},{"key":"e_1_2_6_90_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.12r08064"},{"key":"e_1_2_6_91_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2015.2955"},{"key":"e_1_2_6_92_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2012.02.030"},{"key":"e_1_2_6_93_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20516"},{"key":"e_1_2_6_94_1","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbs150"}],"container-title":["World Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fwps.20632","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wps.20632","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/wps.20632","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wps.20632","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T18:20:47Z","timestamp":1694370047000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/wps.20632"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,6]]},"references-count":93,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1002\/wps.20632"],"URL":"https:\/\/doi.org\/10.1002\/wps.20632","archive":["Portico"],"relation":{},"ISSN":["1723-8617","2051-5545"],"issn-type":[{"value":"1723-8617","type":"print"},{"value":"2051-5545","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,6]]},"assertion":[{"value":"2019-05-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}