Cochrane · systematic review · CD006324
Clozapine combined with different antipsychotic drugs for treatment‐resistant schizophrenia
Barber, S, Olotu, U, Corsi, M, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
SchizophreniaAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
35
current version
GRADE rated
17
No studies
13
Included studies
NR
No studies 13 · 37.1%Ungraded 5 · 14.3%Very low 12 · 34.3%Low 5 · 14.3%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
CLOZAPINE + ARIPIPRAZOLE versus CLOZAPINE + HALOPERIDOL (Cipriani 2013)
Population: people with treatment‐resistant schizophrenia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical response: no clinically significant response in mental state CLOZAPINE + ARIPIPRAZOLE vs CLOZAPINE + HALOPERIDOL (Cipriani 2013) | no estimate extracted | NR | No studies |
Adverse effects: weight gain CLOZAPINE + ARIPIPRAZOLE vs CLOZAPINE + HALOPERIDOL (Cipriani 2013) | no estimate extracted | NR | No studies |
Clinical response: mean score/change in global state CLOZAPINE + ARIPIPRAZOLE vs CLOZAPINE + HALOPERIDOL (Cipriani 2013) | no estimate extracted | NR | No studies |
Clinical response: mean score/change in mental state: change in BPRS score from baseline (high = good), Long term (12 months) CLOZAPINE + ARIPIPRAZOLE vs CLOZAPINE + HALOPERIDOL (Cipriani 2013) | no estimate extracted | 1 study · 105 participants | Low Downgraded: risk of bias |
Leaving the study early: acceptability of treatment ‐ as measured by completion of trial Long term (12 months) CLOZAPINE + ARIPIPRAZOLE vs CLOZAPINE + HALOPERIDOL (Cipriani 2013) | RR 1.27 [0.72, 2.22] | 1 study · 106 participants | Very low Downgraded: risk of bias |
Service utilisation outcomes: hospital admission or days in hospital CLOZAPINE + ARIPIPRAZOLE vs CLOZAPINE + HALOPERIDOL (Cipriani 2013) | no estimate extracted | NR | No studies |
Quality of life/satisfaction with care for either recipients of care or carers: significant change in quality of life/satisfaction CLOZAPINE + ARIPIPRAZOLE vs CLOZAPINE + HALOPERIDOL (Cipriani 2013) | no estimate extracted | NR | No studies |
CLOZAPINE + AMISULPIRIDE versus CLOZAPINE + QUETIAPINE (Genc 2007)
Population: people with treatment‐resistant schizophrenia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical response: no clinically significant response in mental state CLOZAPINE + AMISULPIRIDE vs CLOZAPINE + QUETIAPINE (Genc 2007) | no estimate extracted | 1 study · 1 participants | Ungraded |
Adverse effects: weight gain CLOZAPINE + AMISULPIRIDE vs CLOZAPINE + QUETIAPINE (Genc 2007) | no estimate extracted | 1 study · 1 participants | Ungraded |
Clinical response: mean score/change in global state: mean CGI score (high = poor) Short term (8 weeks) CLOZAPINE + AMISULPIRIDE vs CLOZAPINE + QUETIAPINE (Genc 2007) | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias |
Clinical response: mean score/change in mental state: mean BPRS score (high = poor) Short term (8 weeks) CLOZAPINE + AMISULPIRIDE vs CLOZAPINE + QUETIAPINE (Genc 2007) | no estimate extracted | 1 study · 50 participants | Low Downgraded: risk of bias |
Leaving the study early: acceptability of treatment ‐ as measured by completion of trial CLOZAPINE + AMISULPIRIDE vs CLOZAPINE + QUETIAPINE (Genc 2007) | RR 0.2 [0.02, 1.6] | 1 study · 56 participants | Very low Downgraded: risk of bias |
Service utilisation outcomes: hospital admission or days in hospital CLOZAPINE + AMISULPIRIDE vs CLOZAPINE + QUETIAPINE (Genc 2007) | no estimate extracted | 1 study · 1 participants | Ungraded |
Quality of life/satisfaction with care for either recipients of care or carers: significant change in quality of life/satisfaction CLOZAPINE + AMISULPIRIDE vs CLOZAPINE + QUETIAPINE (Genc 2007) | no estimate extracted | 1 study · 1 participants | Ungraded |
CLOZAPINE + RISPERIDONE versus CLOZAPINE + SULPIRIDE (Kong 2001)
Population: people with treatment‐resistant schizophrenia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical response: no clinically significant response in mental state: 20% to 50% reduction in PANSS total score CLOZAPINE + RISPERIDONE vs CLOZAPINE + SULPIRIDE (Kong 2001) | RR 0.82 [0.4, 1.68] | 1 study · 60 participants | Very low Downgraded: risk of bias |
Adverse effects: weight gain CLOZAPINE + RISPERIDONE vs CLOZAPINE + SULPIRIDE (Kong 2001) | RR 0.4 [0.08, 1.9] | 1 study · 60 participants | Very low Downgraded: risk of bias |
Clinical response: mean score/change in global state CLOZAPINE + RISPERIDONE vs CLOZAPINE + SULPIRIDE (Kong 2001) | no estimate extracted | 1 study · 1 participants | Ungraded |
Clinical response: mean score/change in mental state: mean PANSS total score (high = poor) CLOZAPINE + RISPERIDONE vs CLOZAPINE + SULPIRIDE (Kong 2001) | no estimate extracted | 1 study · 60 participants | Very low Downgraded: risk of bias |
Leaving the study early: acceptability of treatment ‐ as measured by completion of trial CLOZAPINE + RISPERIDONE vs CLOZAPINE + SULPIRIDE (Kong 2001) | no estimate extracted | 1 study · 60 participants | Very low Downgraded: risk of bias |
Service utilisation outcomes: hospital admission or days in hospital CLOZAPINE + RISPERIDONE vs CLOZAPINE + SULPIRIDE (Kong 2001) | no estimate extracted | NR | No studies |
Quality of life/satisfaction with care for either recipients of care or carers: significant change in quality of life/satisfaction CLOZAPINE + RISPERIDONE vs CLOZAPINE + SULPIRIDE (Kong 2001) | no estimate extracted | NR | No studies |
CLOZAPINE + RISPERIDONE versus CLOZAPINE + ZIPRASIDONE (Kuwilsky 2010)
Population: people with treatment‐resistant schizophrenia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical response: no clinically significant response in mental state: 20% reduction in PANSS total score Medium term (26 weeks) CLOZAPINE + RISPERIDONE vs CLOZAPINE + ZIPRASIDONE (Kuwilsky 2010) | RR 0.8 [0.28, 2.27] | 1 study · 24 participants | Very low Downgraded: risk of bias |
Adverse effects: weight gain CLOZAPINE + RISPERIDONE vs CLOZAPINE + ZIPRASIDONE (Kuwilsky 2010) | no estimate extracted | NR | No studies |
Clinical response: mean score/change in global state: mean CGI‐II Global improvement score (high = poor) Short term (6 weeks) CLOZAPINE + RISPERIDONE vs CLOZAPINE + ZIPRASIDONE (Kuwilsky 2010) | no estimate extracted | 1 study · 22 participants | Very low Downgraded: risk of bias |
Clinical response: mean score/change in mental state: mean PANSS total score (high = poor) Medium term (26 weeks) CLOZAPINE + RISPERIDONE vs CLOZAPINE + ZIPRASIDONE (Kuwilsky 2010) | no estimate extracted | 1 study · 16 participants | Very low Downgraded: risk of bias |
Leaving the study early: acceptability of treatment ‐ as measured by completion of trial Long term (52 weeks) CLOZAPINE + RISPERIDONE vs CLOZAPINE + ZIPRASIDONE (Kuwilsky 2010) | RR 1.6 [0.73, 3.49] | 1 study · 24 participants | Very low Downgraded: risk of bias |
Service utilisation outcomes: hospital admission or days in hospital CLOZAPINE + RISPERIDONE vs CLOZAPINE + ZIPRASIDONE (Kuwilsky 2010) | no estimate extracted | NR | No studies |
Quality of life/satisfaction with care for either recipients of care or carers: significant change in quality of life/satisfaction CLOZAPINE + RISPERIDONE vs CLOZAPINE + ZIPRASIDONE (Kuwilsky 2010) | no estimate extracted | NR | No studies |
CLOZAPINE + ZIPRASIDONE versus CLOZAPINE + QUETIAPINE (Wen 2015)
Population: people with treatment‐resistant schizophrenia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical response: no clinically significant response in mental state: ≥ 50% reduction in PANSS total score Medium term (12 weeks) CLOZAPINE + ZIPRASIDONE vs CLOZAPINE + QUETIAPINE (Wen 2015) | RR 0.54 [0.35, 0.81] | 1 study · 63 participants | Low Downgraded: risk of bias |
Adverse effects: weight gain CLOZAPINE + ZIPRASIDONE vs CLOZAPINE + QUETIAPINE (Wen 2015) | no estimate extracted | NR | No studies |
Clinical response: mean score/change in global state: mean CGI‐S score (high = poor) Medium term (12 weeks) CLOZAPINE + ZIPRASIDONE vs CLOZAPINE + QUETIAPINE (Wen 2015) | no estimate extracted | 1 study · 60 participants | Low Downgraded: risk of bias |
Clinical response: mean score/change in mental state: mean PANSS total score (high = poor) Medium term (12 weeks) CLOZAPINE + ZIPRASIDONE vs CLOZAPINE + QUETIAPINE (Wen 2015) | no estimate extracted | 1 study · 60 participants | Low Downgraded: risk of bias |
Leaving the study early: acceptability of treatment ‐ as measured by completion of trial CLOZAPINE + ZIPRASIDONE vs CLOZAPINE + QUETIAPINE (Wen 2015) | RR 0.52 [0.05, 5.41] | 1 study · 63 participants | Very low Downgraded: risk of bias |
Service utilisation outcomes: hospital admission or days in hospital CLOZAPINE + ZIPRASIDONE vs CLOZAPINE + QUETIAPINE (Wen 2015) | no estimate extracted | NR | No studies |
Quality of life/satisfaction with care for either recipients of care or carers: significant change in quality of life/satisfaction CLOZAPINE + ZIPRASIDONE vs CLOZAPINE + QUETIAPINE (Wen 2015) | no estimate extracted | NR | No studies |