***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: Remoxipride and clozapine are new neuroleptics that are thought to be superior to the substances in use by their efficacy and tolerance . At the University Clinic of Psychiatry in Dusseldorf a double‐blind study with 54 patients diagnosed as schizophrenic in accordance with DSM‐III was conducted to record the influence of the neuroleptics remoxipride , clozapine and haloperidol on  schizophrenic psychosis . The schizophrenic symptoms were rated by the AMDP‐system ( Arbeitsgemeinschaft fur Method ik und Dokumentation in der Psychiatrie ) , Brief Psychiatric Rating Scale and the Clinical Global Impression on days 0 , 7 , 14 , 21 and 28 of treatment to evaluate the degree of change in psychopathology . The tolerance of the neuroleptic treatment was checked by the doctor 's overall impression and the somatic findings of the AMDP‐system . All 3 neuroleptics reduced the schizophrenic symptoms to a similar degree but showed differentiation as to their side effects Rationale Studies on emotional processing report that schizophrenic patients present a specific pattern of emotional responding that usually includes deficits in emotional expressiveness , increased feelings of unpleasant emotion but decreased feelings of pleasant emotion , and increased physiological reactivity . However , studies have rarely controlled the nature of antipsychotic medication . Yet , the influence of these drugs on emotional response is uncertain and could vary depending on their pharmacological profile . Objective This prospect i ve and r and omized study aim ed to compare the effects of an atypical antipsychotic , risperidone , to a typical one , haloperidol , on patients ’ emotional responding during an emotional induction task . Material s and methods Twenty-five schizophrenic patients underwent two emotional and clinical evaluations : one before treatment initiation and a second 4 weeks after . Emotional states of fear , sadness , anger , joy , and disgust were induced , as well as a neutral baseline state . Video recordings of patients during the induction task allowed for assessment of emotional expressiveness . Self-reports and measures of skin conductance and heart rate were performed to determine both subjective and physiological reactions to emotional experience . Results Compared to haloperidol , risperidone did not reduce patients ’ facial expressiveness , decreased physiological reactivity , and decreased experience of unpleasant emotion but maintained experience of pleasant emotion . Emotional expressiveness was negatively correlated to parkisonism . Conclusions Our preliminary results suggest that atypical antipsychotics allow for better-adapted patterns of emotional responding than typical ones do . We suggest that this effect is due to reduced striatal D2 blockade , therefore , attenuating akinesia , coupled with increased 5HT and DA levels in prefrontal cortex , which improves emotional regulation Rationale To enhance the effectiveness of antipsychotics  in first-episode psychosis is crucial in order to achieve the most favourable prognosis . Difference in effectiveness between antipsychotics is still under debate . Objective The purpose of this study is to determine the long-term ( 3-year ) effectiveness and efficacy of haloperidol , risperidone and olanzapine in first-episode schizophrenia-spectrum disorders . Method This is a prospect i ve , r and omized , open-label study . Data for the present investigation were obtained from a large epidemiologic and 3-year longitudinal intervention programme of first-episode psychosis . One hundred seventy-four patients were r and omly assigned to haloperidol ( N = 56 ) , olanzapine ( N = 55 ) , or risperidone ( N = 63 ) and followed up for 3 years . The primary effectiveness measure was all-cause of treatment discontinuation . In addition , an analysis based on per- protocol population s was conducted in the analysis for clinical efficacy . Results The treatment discontinuation rate for any cause differed significantly between treatment groups ( χ2 = 10.752 ; p = 0.005 ) , with a higher rate in haloperidol than in risperidone and olanzapine . The difference in the discontinuation rate between risperidone and olanzapine showed a tendency towards significance ( χ2 = 3.022 ; p = 0.082 ) . There was a significant difference in the mean time to all-cause discontinuation between groups ( log-rank χ2 = 12.657;df = 2 ; p = 0.002 ) . There were no significant advantages to any of the three treatments in reducing the psychopathology severity . Conclusions After 3 years of treatment , a lower effectiveness was observed in haloperidol compared to second-generation antipsychotics ( SGAs ) . The use of SGAs for the treatment of early phases of nonaffective psychosis may enhance the effectiveness of antipsychotics Patients with first-episode schizophrenia appear to respond to lower doses of neuroleptics , and to be more sensitive to developing extrapyramidal side-effects . The authors therefore compared in such patients the efficacy and extrapyramidal tolerability of comparatively low dosages of the atypical neuroleptic risperidone and of the conventional neuroleptic haloperidol . Risperidone was hypothesized to have better extrapyramidal tolerability and efficacy in treating negative symptoms . Patients were r and omly assigned under double-blind conditions to receive risperidone ( n=143 ) or haloperidol ( n=146 ) for 8 wk . The primary efficacy criterion was the estimated difference in the mean change in the Positive and Negative Symptom Scale ( PANSS ) negative score between treatment groups ; secondary efficacy criteria were changes on the PANSS total score and other PANSS subscores , and several other measures of psychopathology and general functioning . The primary tolerability criterion was the difference in baseline-adjusted occurrence rates of extrapyramidal side-effects measured with the Simpson-Angus Scale ( SAS ) compared between treatment groups . The main hypothesis was that risperidone would be superior in terms of improving negative symptoms and lowering the risk of extrapyramidal symptoms . Secondary tolerability criteria were the other extrapyramidal symptoms , measured with the Hillside Akathisia Scale ( HAS ) and the Abnormal Involuntary Movement Scale ( AIMS ) . The average mean daily doses were 3.8 mg ( s.d.=1.5 ) for risperidone and 3.7 mg ( s.d.=1.5 ) for haloperidol . There were similar , significant improvements in both treatment groups in the primary and secondary efficacy criteria . At week 8 nearly all scores of extrapyramidal side-effects indicated a significantly higher prevalence of extrapyramidal side-effects with haloperidol than with risperidone [ SAS : risperidone 36.5 % of patients ; haloperidol 51.5 % of patients ; likelihood ratio test , chi2(1)=7.8 , p=0.005 ] . There were significantly fewer drop-outs  [ risperidone n=55 , drop-out rate=38.5 % ; haloperidol n=79 , drop-out rate=54.1 % , chi2(1)=7.1 , p=0.009 ] and a longer non-discontinuation time  [ risperidone : average of 50.8 d to drop-out ; haloperidol : average of 44.0 d to drop-out ; log rank test , chi2(1)=6.4 , p=0.011 ] in the risperidone group . Risperidone and haloperidol appear to be equally effective in treating negative and other symptoms of first-episode schizophrenia .  Risperidone has better extrapyramidal tolerability and treatment retention rate than the equivalent dose of haloperidol in these patients 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 The differential effects of so-called ' first- and second generation ' antipsychotic medications , when given in the first episode , on the long-term outcome of schizophrenia remain to be eluci date d. AIMS We compared the 9-year outcomes of individuals initially r and omised to clozapine or chlorpromazine . METHOD One-hundred and sixty individuals with treatment-naive , first episode schizophrenia or schizophreniform disorder in a mental health centre in Beijing , China were r and omised to clozapine or chlorpromazine treatment for up to 2 years , followed by up to an additional 7 years of naturalistic treatment . The primary outcome was remission status for individuals in each group . RESULTS Individuals in both groups spent essentially equal amounts of time in each clinical state over the follow-up time period(remission , 78 % ; intermediate , 8 % ; relapse , 14 % ) . There were no significant differences on other measures of illness severity . The clozapine group was more likely than the chlorpromazine group to remain on the medication to which they were originally assigned ( 26 % v. 10 % , P = 0.01 ) . There were no significant differences between the two groups on other secondary efficacy outcomes . CONCLUSIONS These findings support the comparability in effectiveness between antipsychotic medications but with slightly greater tolerability of clozapine in the treatment of first-episode psychosis BACKGROUND The purpose of this investigation was to test the efficacy of novel antipsychotic medications in the treatment of  cognitive impairment in early phase schizophrenia . METHODS Sixty-five patients in this multicenter double-blind study were r and omly assigned to olanzapine ( 5 - 20 mg ) , risperidone ( 4 - 10 mg ) , or haloperidol ( 5 - 20 mg ) . St and ard measures of clinical and motor syndromes were administered , as well as a comprehensive battery of tests to assess ( 1 ) motor skills , ( 2 ) attention span , ( 3 ) verbal fluency and reasoning , ( 4 ) nonverbal fluency and construction , ( 5 ) executive skills , and ( 6 ) immediate recall at baseline and after 6 , 30 , and 54 weeks of treatment . RESULTS The general cognitive index derived from the 6 domain scores revealed a significantly greater benefit from treatment with olanzapine relative to haloperidol and olanzapine relative to risperidone , but no significant difference was shown between risperidone and haloperidol . The improvement related to olanzapine was apparent after 6 weeks and enhanced after 30 and 54 weeks of treatment . Exploratory within-group analyses of the 6 cognitive domains after a conservative Bonferroni adjustment revealed a significant improvement with olanzapine only on the immediate recall domain , and similar analyses of the 17 individual tests revealed a significant improvement with olanzapine only on the Hooper Visual Organization Test . CONCLUSIONS These data suggest that olanzapine has some superior cognitive benefits relative to haloperidol and risperidone . A larger sample replication study is necessary to confirm and generalize the observations of this study and begin evaluation of the implication s of this change to cerebral function and quality of life for people with schizophrenia 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 4 
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DATA SYNTHESIS Few differences of clinical importance were found for core illness symptoms ; lack of precision in effect estimates precluded firm conclusions for many comparisons .
Moderate-strength evidence showed a clinical ly important benefit of haloperidol over olanzapine for improving positive symptoms , but the benefit was scale-dependent : It was seen when the Scale for the Assessment of Positive Symptoms was used but not when the Positive and Negative Syndrome Scale ( PANSS ) was used .
Moderate-strength evidence showed a clinical ly important benefit of olanzapine over haloperidol in improving negative symptoms when the PANSS and the Scale for the Assessment of Negative Symptoms were used .
Evidence was insufficient to draw conclusions for diabetes mellitus .
Clear benefits of FGAs versus SGAs for treating schizophrenia remain inconclusive because of variation in assessing outcomes and lack of clinical ly important differences for most comparisons .