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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

SO278

Efficacy and side effect profiles of antipsychotics: a comprehensive network meta-analysis

EFFICACY AND SIDE EFFECT PROFILE OF ANTIPSYCHOTICS: A COMPREHENSIVE NETWORK META-ANALYSIS

Clozapine ranks highest in overall efficacy and remains the first-choice treatment for treatment-resistant cases, while olanzapine provides similar efficacy with fewer side effects.

The aim is to compare the efficacy and side effect profiles of different antipsychotics to guide the selection of an agent suited to each patient's individual profile. Multiple electronic databases were searched using the keywords "Antipsychotics", "Side effects", "Efficacy", and "Schizophrenia"; studies were selected in accordance with PRISMA guidelines, and, according to the poster, 44 research articles containing data from more than 5,500 patients were included (the conference abstract reported approximately 65 articles and more than 7,000 patients). The antipsychotics evaluated included clozapine, olanzapine, risperidone, haloperidol, chlorpromazine, quetiapine, and various long-acting formulations; data synthesis and network meta-analyses were conducted using RevMan, Meta-Insight, and CINeMA. Compared with clozapine, the standardized mean difference (SMD) values for the overall primary outcome were reported as 0.43 [95% confidence interval 0.21; 0.66] for chlorpromazine, 0.44 [0.19; 0.69] for quetiapine, 0.49 [0.02; 0.97] for sertindole, 0.29 [0.11; 0.48] for haloperidol, 0.17 [-0.01; 0.35] for risperidone, 0.02 [-0.14; 0.18] for olanzapine, 0.20 [-0.15; 0.55] for ziprasidone, 0.08 [-0.59; 0.75] for zotepine, 0.36 [-0.14; 0.85] for fluphenazine, and -0.27 [-1.05; 0.52] for levomepromazine; for the response outcome, the risk ratio versus clozapine was 0.74 [0.59; 0.92] for haloperidol and 1.15 [0.43; 2.36] for aripiprazole. In the poster's ranking table, clozapine ranked first and olanzapine second for overall efficacy; olanzapine ranked first and clozapine second for positive symptoms; olanzapine ranked first and zotepine second for negative symptoms; and aripiprazole ranked first and perphenazine second for response rate (the poster text, however, states that clozapine ranked first for overall efficacy and positive symptoms). Clozapine reduced treatment discontinuation rates and was better tolerated than other medications, but both clozapine and olanzapine caused substantial weight gain. In conclusion, clozapine remains the first-choice treatment for treatment-resistant cases, with the lowest treatment failure rate and the highest efficacy; olanzapine provides comparable efficacy with fewer side effects; ziprasidone and zotepine may be alternatives when side effects are intolerable; and problems associated with weight gain should be considered when selecting treatment.

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