TY  - JOUR
PY  - 2021//
TI  - Effects on suicidal risk: comparison of clozapine to other newer medicines indicated to treat schizophrenia or bipolar disorder
JO  - Journal of psychopharmacology
A1  - Forte, Alberto
A1  - Pompili, Maurizio
A1  - Imbastaro, Benedetta
A1  - De Luca, Gabriele Pasquale
A1  - Mastrangelo, Martina
A1  - Montalbani, Benedetta
A1  - Baldessarini, Ross J.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: Clozapine is the only treatment with regulatory-recognition of lowering suicidal risk, at least in schizophrenia patients. It remains uncertain whether such effects extend to other drugs for psychosis. <br><br>METHODS: We searched for reports on rates of suicidal behavior during treatment with clozapine and other modern drugs for psychosis (aripiprazole, olanzapine, risperidone, quetiapine, and ziprasidone) versus comparison or control treatments and analyzed the contrasts by random-effect meta-analysis to obtain pooled odds ratios (ORs) with 95% confidence intervals (CIs). <br><br>RESULTS: We identified 35 paired comparisons of modern drugs for psychosis versus comparison or control treatments in 18 reports. There was moderate overall superiority of all agents tested over alternatives (OR = 0.522, p = 0.004). With clozapine, this effect was large (OR = 0.229, p < 0.0001) and consistent (7/7 trials), but significant antisuicidal effects were not found with other drugs for psychosis in 28 other trials (OR = 0.941, p = 0.497). Apparent efficacy of specific agents ranked: risperidone ⩾ olanzapine ⩾ aripiprazole ⩾ ziprasidone ⩾ mixed drugs for psychosis ⩾ quetiapine, but none of these differences was significant. <br><br>CONCLUSIONS: An ability of clozapine to reduce risk of suicides and attempts in schizophrenia patients appears to be a unique effect not shared with other modern medicines indicated for schizophrenia or bipolar disorder.<p />  <p>Language: en</p>
LA  - en
SN  - 0269-8811
UR  - http://dx.doi.org/10.1177/02698811211029738
ID  - ref1
ER  -