Amisulpride versus placebo in the medium-term treatment of the negative symptoms of schizophrenia

Lôo, Henri; Poirier-Littre, M. F.; Theron, Michel; Rein, W.; Fleurot, O.

doi:10.1192/bjp.170.1.18

Cited by 175 publications

(91 citation statements)

References 7 publications

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“…6 patients with acute exacerbations of schizophrenia have shown that amisulpride is as effective as haloperidol and flupenthixol in treating positive symptoms (Möller et al 1997;Puech et al 1998;Wetzel et al 1998) with additional effects on negative symptoms compared with haloperidol (Möller et al 1997). Amisulpride significantly reduces negative symptoms in patients with chronic schizophrenia presenting with enduring predominant negative symptoms (Boyer et al 1995;Loo et al 1997;Danion et al 1999) and in neuroleptic naive mainly negative schizophrenics at the onset of the disorder (Paillère-Martinot et al 1995). The efficacy of amisulpride was maintained in an open long-term study, with a clear advantage over haloperidol in terms of safety and efficacy (Colonna et al 2000).…”

mentioning

confidence: 99%

Amisulpride vs. Risperidone in Chronic Schizophrenia Results of a 6-month Double-blind Study

Sechter

Fleurot

Rein

et al. 2002

Neuropsychopharmacology

107

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Schizophrenia is a chronic and disabling disorder with a lifetime prevalence of approximately 1% (American Psychiatric Association 1994). It results in significant long-term functional handicap, severely impairs the quality of life of both the patient and the caregivers and places a considerable financial burden on society.The clinical efficacy of amisulpride against acute psychotic symptoms at high doses (400-800 mg/day) and prominent negative symptoms at low doses (50-300 mg/day) may be explained by its preferential affinity for pre-synaptic dopaminergic D 2 and D 3 autoreceptor subtypes at low doses, while higher doses result in predominant antagonism of post-synaptic dopamine receptors (Perrault et al. 1997;Schoemaker et al. 1997). It also shows selectivity for dopamine receptors in limbic and hippocampal structures, rather than striatal structures, thus suggesting a lower propensity to induce extrapyramidal effects than seen with the classical antipsychotics (Perrault et al. 1997). Studies in

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mentioning

confidence: 99%

Amisulpride vs. Risperidone in Chronic Schizophrenia Results of a 6-month Double-blind Study

Sechter

Fleurot

Rein

et al. 2002

Neuropsychopharmacology

107

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“…We made a sensitivity analysis excluding studies that consisted of patients with predominantly negative symptoms, [18][19][20][21][22][23] long-term studies on initially stable patients [24][25][26][27][28] and one very short study of only 2 weeks duration. 29 Owing to space limitations, we do not show the results here, but any result that deviated to an important extent from the primary analysis will be mentioned.…”

Section: Meta-analytic Calculationsmentioning

confidence: 99%

How effective are second-generation antipsychotic drugs? A meta-analysis of placebo-controlled trials

et al. 2008

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We conducted a systematic review and meta-analysis of randomized controlled trials that compared second-generation antipsychotic (SGA) drugs with placebo in schizophrenic patients and which considered 13 different outcome measures. Thirty-eight randomized controlled trials with 7323 participants were included. All SGA drugs were more effective than placebo, but the pooled effect size (ES) for overall symptoms (primary outcome) was moderate (À0.51). The absolute difference (RD) in responder rates was at 18% (41% responded to drug compared with 24% to placebo, number needed to treat = 6). Similar ESs were found for the other efficacy parameters: negative symptoms (ES = À0.39), positive symptoms (ES = À0.48), depression (ES = À0.26), relapse (RD 20%) and discontinuation due to inefficacy (RD 17%). Curiously, the efficacy of haloperidol for negative and depressive symptoms was similar to that of the SGA drugs. In contrast to haloperidol, there was no difference in terms of EPS between any SGA drugs and placebo, and there was also no difference in terms of dropouts due to adverse events. Meta-regression showed a decline in treatment response over time, and a funnel plot suggested the possibility of publication bias. We conclude that the drug versus placebo difference of SGA drugs and haloperidol in recent trials was moderate, and that there is much room for more efficacious compounds. Whether methodological issues account in part for the relatively low efficacy ESs and the scarcity of adverse event differences compared with placebo needs to be established.

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“…Two trials (Danion 1998, 60 Carriere 2000 47 ) were of medium duration -3-4 months, two trials lasted for 6 months (Lecrubier 1999, 42 Lecrubier 2000 43 ), with the remaining three trials (Colonna 1998, 49 Loo 1997, 63 Speller 1997 59 ) being of 1 year's duration (Loo 1997 was run initially for 6 months with 141 participants, then extended to 12 months for those patients who responded to treatment).…”

Section: Duration Of Studiesmentioning

confidence: 99%

“…At least nine trials (Colonna 1998, 64 Danion 1998, 60 Loo 1997, 63 Moeller 1997, 65 Martinot 1995, 52 Puech 1998, 56 Speller 1997, 59 Fleurot 1997, 62 Carriere 2000 47 ) were carried out or sponsored by Synthelabo, the manufacturers of amisulpride. Nine studies were published only as conference abstracts (including the amisulpride versus risperidone and olanzapine studies) and many methodological details are missing from these reports.…”

Section: Total Rctsmentioning

confidence: 99%

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A systematic review of atypical antipsychotic drugs in schizophrenia

Bagnall

Jones

Ginnelly

et al. 2003

Health Technol Assess

151

114

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Amisulpride versus placebo in the medium-term treatment of the negative symptoms of schizophrenia

Abstract: Amisulpride is effective in the medium-term treatment schizophrenic patients with predominantly negative symptoms.

Cited by 175 publications

References 7 publications

Amisulpride vs. Risperidone in Chronic Schizophrenia Results of a 6-month Double-blind Study

Amisulpride vs. Risperidone in Chronic Schizophrenia Results of a 6-month Double-blind Study

How effective are second-generation antipsychotic drugs? A meta-analysis of placebo-controlled trials

A systematic review of atypical antipsychotic drugs in schizophrenia

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