***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: BACKGROUND The Intercontinental Schizophrenia Outpatient Health Outcomes ( IC-SOHO ) study was design ed to provide information regarding use and outcome of antipsychotic treatments in a large , diverse population in real practice setting s. METHOD Out patients with schizophrenia ( ICD-10 or DSM-IV ) who initiated or changed to a new antipsychotic  entered this 3-year , naturalistic , prospect i ve observational study . Four monotherapy treatment groups were defined according to the antipsychotic prescribed at baseline , namely olanzapine , risperidone , quetiapine , and haloperidol .  Efficacy was assessed using the Clinical Global Impressions-Severity of Illness rating scale ( CGI-S ) , inclusive of subscales for positive , negative , depressive , and cognitive symptoms . Tolerability was assessed by adverse event question naires and weight measurements . Six-month findings are described . RESULTS At baseline , 5833 participants were prescribed monotherapy and the mean severity of illness was moderate to marked ( CGI-S ) . At 6 months , olanzapine result ed in significantly greater improvements in overall , positive , negative , depressive , and cognitive symptoms compared with quetiapine , risperidone or haloperidol ( p < .001 ) . Improvements in overall , negative , and cognitive symptoms were significantly higher for risperidone compared with haloperidol ( p < .001 ) , whereas improvements across all symptoms were comparable for quetiapine and haloperidol . Extra-pyramidal symptoms and tardive dyskinesia decreased compared with baseline in the olanzapine , quetiapine , and risperidone groups but increased in the haloperidol group ( p < .001 , likelihood of extrapyramidal symptoms with haloperidol compared with olanzapine , quetiapine , or risperidone ) . Sexual function adverse events were most prominent in the haloperidol and risperidone treatment groups . Weight change was significantly greater for olanzapine compared with the other antipsychotics ( p < .001 ) . CONCLUSION Our results support the previously reported positive impact of atypical antipsychotics , particularly olanzapine , in patients with schizophrenia To evaluate the maintenance of efficacy of risperidone long‐acting injectable ( RLAI ) in stable patients with schizophrenia or schizoaffective disorders . The prevalence of patients who met st and ardized remission criteria will be also evaluated as well as the predictors factors of remission according to psychopathological , psychosocial and subjective correlates 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 Because wide variations in mental health care utilization exist throughout the world , determining long-term effectiveness of psychotropic medications in a real-world setting would be beneficial to physicians and patients . The purpose of this analysis was to describe the effectiveness of injectable risperidone long-acting therapy ( RLAT ) for schizophrenia across countries . Methods This was a pragmatic analysis of data from two prospect i ve observational studies conducted in the US ( Schizophrenia Outcomes Utilization Relapse and Clinical Evaluation [ SOURCE ] ; Clinical Trials.gov registration number for the SOURCE study : NCT00246194 ) and Spain , Australia , and Belgium ( electronic Schizophrenia Treatment Adherence Registry [ eSTAR ] ) . Two separate analyses were performed to assess clinical improvement during the study and estimate psychiatric hospitalization rates before and after RLAT initiation . Clinical improvement was evaluated using the Clinical Global Impressions-Severity ( CGI-S ) and Global Assessment of Functioning ( GAF ) scales , and change from baseline was evaluated using paired t tests . Psychiatric hospitalization rates were analyzed using incidence densities , and the bootstrap resampling method was used to examine differences between the pre-baseline and post-baseline periods . Results The initial sample comprised 3,069 patients ( US , n = 532 ; Spain , n = 1,345 ; Australia , n = 784 ; and Belgium , n = 408 ) . In all , 24 months of study participation , completed by 39.3 % ( n = 209 ) , 62.7 % ( n = 843 ) , 45.8 % ( n = 359 ) , and 64.2 % ( n = 262 ) of patients from the US , Spain , Australia , and Belgium , respectively , were included in the clinical analysis . Improvements compared with baseline were observed on both clinical assessment s across countries ( P < 0.001 at all post-baseline visits ) . The mean improvement was approximately 1 point on the CGI-S and 15 points on the GAF . A total of 435 ( 81.8 % ) , 1,339 ( 99.6 % ) , 734 ( 93.6 % ) , and 393 ( 96.3 % ) patients from the US , Spain , Australia , and Belgium , respectively , had ≥1 post-baseline visit and were included in the analysis of psychiatric hospitalization rates . Hospitalization rates decreased significantly in all countries regardless of hospitalization status at RLAT initiation ( P < 0.0001 ) and decreased significantly in the US and Spain ( P < 0.0001 ) when the analysis was limited to out patients only . Conclusions RLAT in patients with schizophrenia was associated with improvements in clinical and functional outcomes and decreased hospitalization rates in the US , Spain , Australia , and Belgium , despite differences in health care delivery systems OBJECTIVE Adding another antipsychotic to a treatment regimen was previously used in evaluating the medication 's efficacy . Supplementation of depot antipsychotics with oral antipsychotics is particularly meaningful because depot formulations are typically chosen for patients struggling with adherence to oral antipsychotics . This post-hoc analysis assessed supplementation of olanzapine long-acting injection ( olanzapine-LAI ) with oral olanzapine . SUBJECTS AND METHODS We used 12 months of data from an open-label , single-arm extension study of patients with schizophrenia or schizoaffective disorder ( N=931 ) treated with olanzapine-LAI .  The prevalence , duration , time to first supplementation , and best predictors of oral supplementation were assessed . RESULTS Oral supplementation occurred in 21 % of patients for a median of 31 days with mean modal dose of 10.8 mg/day . Mean time to first supplementation was shorter for patients who were at least moderately ill at baseline compared to less ill patients ( 47 vs. 97 days , p<0.001 ) . Best predictors of oral supplementation included a more severe illness profile at baseline , lower olanzapine-LAI dose prior to oral supplementation , supervised living arrangements , and being African-American . CONCLUSION Supplementation of olanzapine-LAI appears to be infrequent , of relatively short duration , and reserved for more severely ill patients who may require a targeted rescue medication due to signs of impending relapse This study assessed the efficacy and the safety of a dosing regimen that was revised from earlier studies for the investigational injectable atypical antipsychotic paliperidone palmitate ( approved in the USA , August 2009 ) for adult patients with acutely exacerbated schizophrenia . The patients ( N = 652 ) were r and omly assigned ( 1:1:1:1 ) to paliperidone palmitate at 25 , 100 , or 150 mg eq. or placebo in this 13-week double-blind study . The patients received an injection of paliperidone palmitate at 150 mg eq. or placebo in the deltoid muscle on day 1 and the assigned fixed dose or placebo in the deltoid or muscle on day 8 and then once monthly ( days 36 and 64 ) . No oral supplementation was used . Target plasma levels were achieved by day 8 in all paliperidone palmitate groups . The mean change in Positive and Negative Syndrome Scale total score from baseline to end point improved significantly ( P ≤ 0.034 ) in all the paliperidone palmitate dose-groups versus placebo . Paliperidone palmitate treatment with this revised dosing regimen led to the achievement of rapid and consistent therapeutically effective plasma levels that were maintained by once-monthly dosing in either the deltoid or gluteal muscle . Common treatment-emergent adverse events ( ≥2 % of patients in any of the treatment groups ) that occurred more frequently in the total paliperidone palmitate group versus the placebo group ( with ≥1 % difference ) were injection-site pain ( 7.6 % vs 3.7 % ) , dizziness ( 2.5 % vs 1.2 % ) , sedation ( 2.3 % vs 0.6 % ) , pain in the extremity ( 1.6 % vs 0.0 % ) , and myalgia ( 1.0 % vs 0.0 % ) . The paliperidone palmitate treatment was efficacious and generally tolerated across the dose range ( 25 , 100 , or 150 mg eq. ) in adult patients with acutely exacerbated schizophrenia . Abbreviations : BMI - body mass index , CGI-S - Clinical Global Impression-Severity , EPS - extrapyramidal symptoms , ER - extended release , ITT - intent-to-treat , LAI - long-acting injectable , PANSS - Positive and Negative Syndrome Scale , PK - pharmacokinetic , PSP - Personal and Social Performance Scale , TEAE - treatment-emergent adverse events , VAS - Visual Analogue OBJECTIVE The authors assessed the efficacy and safety of the first long-acting atypical antipsychotic ( long-acting injectable risperidone ) in patients with schizophrenia . METHOD In a 12-week , multicenter , double-blind , r and omized study , patients received intramuscular injections every 2 weeks of placebo or long-acting risperidone ( 25 mg , 50 mg , or 75 mg ) . The primary measure of efficacy was the change in total score on the Positive and Negative Syndrome Scale . RESULTS Of the 554 patients who were enrolled , 400 entered the double-blind study , and 370 received at least one postbaseline assessment .  Mean changes in score of -6.2 , -8.5 , and -7.4 on the Positive and Negative Syndrome Scale were seen at endpoint for the 25- , 50- , and 75-mg risperidone groups , respectively ; all three change scores were significantly different from that seen with placebo ( + 2.6 ) . Improvements in positive and negative symptoms were also significantly greater in patients receiving risperidone . Long-acting risperidone was well tolerated . Adverse events related to extrapyramidal symptoms were spontaneously reported by 13 % of patients receiving placebo and 10 % of patients in the 25-mg risperidone group , with higher rates in the 50-mg and 75-mg groups . Severity of extrapyramidal symptoms was mild at baseline and throughout the trial in each treatment group . Mean weight changes were small in the 25- , 50- , and 75-mg risperidone groups ( 0.5 kg , 1.2 kg , and 1.9 kg , respectively ) . Injection site pain was rated as low by the patients , consistent with the investigators ' pain ratings . CONCLUSIONS Long-acting injectable risperidone was efficacious and well tolerated and provides both clinicians and patients with a new mode of treatment that can improve the outcome of long-term therapy Abstract Objective To study the association between prescribed antipsychotic drugs and outcome in schizophrenia or schizoaffective disorder in the community . Design Prospect i ve cohort study using national central registers . Setting Community care in Finl and . Participants Nation 
    Output:
    
Conclusion Using treatment-completion rates as a proxy measure of medication effectiveness , olanzapine long-acting injection did not differ significantly from risperidone long-acting injection when including all eligible studies .