FRIDAY, Dec. 5 (HealthDay News) -- The properties of the various second-generation antipsychotic drugs used to treat schizophrenia vary widely in terms of treatment properties and side effects, making comparison with first-generation drugs difficult but enabling individualized treatment, according to an article published online Dec. 5 in The Lancet.

Stefan Leucht, M.D., of the Universitat Munchen in Munich, Germany, and colleagues conducted a meta-analysis of 150 double-blind studies comprising 21,533 subjects, to address the issue of whether or not second-generation antipsychotic drugs for schizophrenia were better than first-generation drugs. Most of the studies were short-term, and open-ended studies were excluded because they had a systematic bias in favor of second-generation drugs.

In terms of overall efficacy, the second-generation drugs amisulpride, clozapine, olanzapine and risperidone were more efficacious than first-generation drugs, the investigators found. However, other second-generation drugs were no more efficacious than their first-generation counterparts, the researchers report. Although the first-generation drug haloperidol induced more extrapyramidal side effects than second-generation drugs, it induced less weight gain than all second-generation drugs except aripiprazole and ziprasidone, the report indicates.

"Because the second-generation antipsychotic drugs differ in many properties, including efficacy, side effects, cost (some are now generic) and pharmacology (amisulpride is not a serotonin receptor blocker), they do not form a homogeneous class and neither do first-generation antipsychotic drugs," the authors write. "This meta-analysis provides data that clinicians could use for individualized treatment of patients."

Leucht reports financial relationships with the pharmaceutical industry.

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