***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE Despite the frequent use of the Positive and Negative Syndrome Scale ( PANSS ) for rating the symptoms of schizophrenia , the clinical meaning of its total score and of the cut-offs that are used to define treatment response ( e.g. at least 20 % or 50 % reduction of the baseline score ) are as yet unclear . We therefore compared the PANSS with simultaneous ratings of Clinical Global Impressions ( CGI ) . METHOD PANSS and CGI ratings at baseline ( n = 4091 ) , and after one , two , four and six weeks of treatment taken from a pooled data base of seven pivotal , multi-center antipsychotic drug trials on olanzapine or amisulpride in patients with exacerbations of schizophrenia were compared using equipercentile linking . RESULTS Being considered " mildly ill " according to the CGI approximately corresponded to a PANSS total score of 58 , " moderately ill " to a PANSS of 75 , " markedly ill " to a PANSS of 95 and severely ill to a PANSS of 116 . To be " minimally improved " according to the CGI score was associated with a mean percentage PANSS reduction of 19 % , 23 % , 26 % and 28 % at weeks 1 , 2 , 4 and 6 , respectively . The corresponding figures for a CGI rating " much improved " were 40 % , 45 % , 51 % and 53 % . CONCLUSIONS The results provide a better framework for underst and ing the clinical meaning of the PANSS total score in drug trials of schizophrenia patients with acute exacerbations . Such studies may ideally use at least a 50 % reduction from baseline cut-off to define response rather than lower thresholds . In treatment resistant population s , however , even a small improvement can be important , so that a 25 % cut-off might be appropriate BACKGROUND Typical antipsychotic drugs frequently cause hyperprolactinemia and even galactorrhea . In addition , these side effects may result in noncompliance with antipsychotic treatment . Capacity to avoid hyperprolactinemia has been accepted as one atypical criterion . The aim of the present study was to compare effects of haloperidol , the most commonly used antipsychotic , and quetiapine , a novel antipsychotic agent used in Turkey , on serum prolactin ( PRL ) levels . METHODS The study consisted of 35 females diagnosed with schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders , 4(th ) ed . ( DSM-IV ) . Thirty-five patients in a drug-free period for at least 2 weeks were included to r and omized quetiapine ( n = 18 ) and haloperidol ( n = 17 ) treatment group . All patients were assessed by Brief psychiatric rating scale ( BPRS ) , Positive and negative syndrome scale ( PANSS ) , and Extrapyramidal symptoms rating scale ( ESRS ) . PRL levels were measured both at the beginning and at the sixth week of the study . RESULTS Both treatment groups exhibited significant improvements in clinical signs as evaluated by BPRS and PANSS . While there was no significant difference in PRL level between groups at the beginning of the study , control prolactin ( PRL ) levels were significantly lower in quetiapine compared to haloperidol group . While no quetiapine group patients exhibited galactorrhea , we observed that two patients from the haloperidol group had galactorrhea related to hyperprolactinemia . CONCLUSIONS The present study revealed that quetiapine is not associated with increase in PRL secretion in contrast to the conventional antipsychotic haloperidol BACKGROUND Quetiapine ( ICI 204,636 , ' Seroquel ' ) is a new atypical antipsychotic agent with a similar binding profile to the original atypical antipsychotic , clozapine . Its clinical efficacy has already been demonstrated at multiple fixed doses ( 150 - 750 mg/day ) and has been suggested to be comparable with haloperidol ( 12 mg/day ) . METHODS This international , 6-week , multicentre , double-blind , r and omized , parallel-group trial compared quetiapine with haloperidol ( 455 mg and 8 mg mean total daily doses , respectively ) in 448 hospitalized patients with acute exacerbation of chronic or subchronic schizophrenia ( DSM-III-R ) , in order to establish their equivalence in terms of efficacy , and the nature of their tolerability profiles , especially in terms of extrapyramidal symptoms ( EPS ) and serum prolactin levels . RESULTS Both quetiapine and haloperidol produced a clear reduction in the Positive and Negative Syndrome Scale ( PANSS ) scores and Clinical Global Impression ( CGI ) Severity of Illness and Global Improvement scores . At day 42 , the PANSS total score was reduced by -18.7+/-1.63 in the quetiapine group , and -22.1+/-1.63 in the haloperidol group ( P = 0.13 , between-treatment ) . Quetiapine was better tolerated than haloperidol in terms of EPS as demonstrated by the significant differences in the Simpson Scale and Abnormal Involuntary Movement Scale scores ( P < 0.05 ) . Although patients in both groups had elevated serum prolactin concentrations at baseline , mean serum prolactin concentration decreased ( by 16.5 microg/l ) in quetiapine-treated patients , yet increased ( by 5.9 microg/l ) in patients treated with haloperidol . CONCLUSION Quetiapine is an effective and well tolerated antipsychotic of comparable efficacy to haloperidol and lacks the latter compound 's effect on prolactin and EPS CONTEXT Second-generation ( atypical ) antipsychotics ( SGAs ) are more expensive than first-generation ( typical ) antipsychotics ( FGAs ) but are perceived to be more effective , with fewer adverse effects , and preferable to patients . Most evidence comes from short-term efficacy trials of symptoms . OBJECTIVE To test the hypothesis that in people with schizophrenia requiring a change in treatment , SGAs other than clozapine are associated with improved quality of life across 1 year compared with FGAs . DESIGN A noncommercially funded , pragmatic , multisite , r and omized controlled trial of antipsychotic drug classes , with blind assessment s at 12 , 26 , and 56 weeks using intention-to-treat analysis . SETTING Fourteen community psychiatric services in the English National Health Service . PARTICIPANTS Two hundred twenty-seven people aged 18 to 65 years with DSM-IV schizophrenia and related disorders assessed for medication review because of inadequate response or adverse effects . INTERVENTIONS R and omized prescription of either FGAs or SGAs ( other than clozapine ) , with the choice of individual drug made by the managing psychiatrist . MAIN OUTCOME MEASURES Quality of Life Scale scores , symptoms , adverse effects , participant satisfaction , and costs of care . RESULTS The primary hypothesis of significant improvement in Quality of Life Scale scores during the year after commencement of SGAs vs FGAs was excluded . Participants in the FGA arm showed a trend toward greater improvements in Quality of Life Scale and symptom scores . Participants reported no clear preference for either drug group ; costs were similar . CONCLUSIONS In people with schizophrenia whose medication is changed for clinical reasons , there is no disadvantage across 1 year in terms of quality of life , symptoms , or associated costs of care in using FGAs rather than nonclozapine SGAs . Neither inadequate power nor patterns of drug discontinuation accounted for the result BACKGROUND While the atypical antipsychotics should ultimately reduce the prevalence of tardive dyskinesia , it is likely to remain a significant clinical problem for a long time to come . No strategy has clearly emerged as the treatment of choice for tardive dyskinesia .  Atypical antipsychotics have reduced propensities for producing acute extrapyramidal symptoms ( EPS ) and possibly tardive dyskinesia and may be effective in treating patients with established tardive dyskinesia . METHOD This 12-month , r and omized , investigator-blinded study compared the efficacy of quetiapine  ( N = 22 ) and haloperidol  ( N = 23 ) in treating patients with DSM-IV schizophrenia or schizoaffective disorder and established tardive dyskinesia .  Dyskinesia was assessed using the Extrapyramidal Symptom Rating Scale ( ESRS ) dyskinesia subscale scores and the Clinical Global Impression ( CGI ) dyskinesia scores . Other EPS , weight , serum prolactin level , and glycosylated hemoglobin level were also assessed . Subjects were enrolled in the study between April 2000 and March 2002 . RESULTS Mean endpoint doses were 400 mg/day of quetiapine and 8.5 mg/day of haloperidol . Compared with the haloperidol group , the quetiapine group showed significantly greater improvements in ESRS dyskinesia ( 6 and 9 months [ p < or=.01 ] ) and CGI dyskinesia ( from 6 months onward [ p < .05 ] and with repeated- measures analysis [ p = .002 ] ) . Response rate ( > or= 50 % symptom reduction ) was greater with quetiapine than haloperidol ( 64 % [ 9/14 ] and 37 % [ 6/16 ] at 6 months ; 55 % [ 6/11 ] and 28 % [ 4/14 ] at 12 months ) . Other EPS decreased significantly with quetiapine at 3 ( p = .01 ) , 6 ( p = .01 ) , and 9 ( p = .002 ) months . Serum prolactin levels decreased with quetiapine but increased with haloperidol , differing significantly between the groups at endpoint ( p = .005 ) . No significant changes in weight or glucose metabolism were recorded in either group . CONCLUSION Quetiapine effectively reduces the severity of tardive dyskinesia and is well tolerated in patients with established tardive dyskinesia The authors estimated components of variance and intraclass correlation coefficients ( ICCs ) to aid in the design of complex surveys and community intervention studies by analyzing data from the Health Survey for Engl and 1994 . This cross-sectional survey of English adults included data on a range of lifestyle risk factors and health outcomes . For the survey , households were sample d in 720 postal code sectors nested within 177 district health authorities and 14 regional health authorities . Study subjects were adults aged 16 years or more .  ICCs and components of variance were estimated from a nested r and om-effects analysis of variance . Results are presented at the district health authority , postal code sector , and household levels . Between-cluster variation was evident at each level of clustering . In these data , ICCs were inversely related to cluster size , but design effects could be substantial when the cluster size was large . Most ICCs were below 0.01 at the district health authority level , and they were mostly below 0.05 at the postal code sector level . At the household level , many ICCs were in the range of 0.0 - 0.3 . These data may provide useful information for the design of epidemiologic studies in which the units sample d or allocated range in size from households to large administrative areas OBJECTIVE To assess the efficacy of quetiapine , a recently introduced second generation antipsychotic medication , in reducing cognitive impairment in patients with schizophrenia . DESIGN Prospect i ve , r and omized , double-blind clinical trial . PATIENTS 25 patients who met the Diagnostic and Statistical Manual of Mental Disorders , fourth edition , ( DSM-IV ) criteria for schizophrenia were recruited from 3 Canadian hospitals . INTERVENTION AND OUTCOME MEASURES After a 48-hour washout period , 25 patients with schizophrenia were r and omly assigned to double-blind treatment with quetiapine or haloperidol for 6 months and evaluated with rating scales for psychotic symptoms , mood and extrapyramidal side effects , as well as st and ardized neuropsychological measures sensitive to 6 cognitive domains : fine motor skill , attention span , verbal reasoning and fluency , visuospatial construction and fluency , executive skills and visuomotor tracking , and immediate recall of verbal and nonverbal material s. The measures were repeated 8 weeks and 6 months after treatment was initiated . RESULTS Quetiapine improved psychosis and mood without inducing extrapyramidal symptoms . Quetiapine also had beneficial effects on cognitive skills , particularly verbal reasoning and fluency skills and immediate recall , with additional improvements on executive skills and visuomotor tracking and on the average of the 6 cognitive domains with sustained treatment . Patients taking haloperidol showed improvements in general clinical status , but no specific improvements on the positive syndrome , the negative syndrome , depression ratings or cognitive skills . CONCLUSIONS These preliminary results support the potential value of quetiapine for improving cognitive impairment in patients with schizophrenia and emphasize the importance of further research with this promising atypical antipsychotic BACKGROUND Second-generation antipsychotic drugs were introduced over a decade ago for the treatment of schizophrenia ; however , their purported clinical effectiveness compared with first-generation antipsychotic drugs is still debated . We aim ed to compare the effectiveness of second-generation antipsychotic drugs with that of a low dose of haloperidol , in first-episode schizophrenia . METHODS We did an open r and omised controlled trial of haloperidol versus second-generation antipsychotic drugs in 50 sites , 
    Output:
    
Quetiapine may not differ from typical antipsychotics in the treatment of positive symptoms and general psychopathology .
There are no clear differences in terms of the treatment of negative symptoms .
However , it causes fewer adverse effects in terms of abnormal ECG , extrapyramidal effects , abnormal prolactin levels and weight gain