***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 C-reactive protein ( CRP ) , intercellular adhesion molecule-1 ( ICAM-1 ) , vascular cell adhesion molecule-1 ( VCAM-1 ) , and E-selectin are systemic inflammatory markers ( IM ) that positively correlate with cardiovascular ( CV ) risk . Despite the known CV effects of atypical antipsychotics , there is limited prospect i ve data on IM changes during treatment . METHODS The IM outcomes were compared between  antipsychotic treatment groups in the CATIE ( Clinical Antipsychotic Trials of Intervention Effectiveness ) schizophrenia trial phase 1 with subjects with laboratory assessment s at baseline and 3 months ( n = 789 ) . RESULTS There were significant treatment differences in CRP , E-selectin , and ICAM-1 at 3 months , with a differential impact of baseline values on the CRP and ICAM-1 results . In overall comparisons , quetiapine and olanzapine had the highest median levels for CRP , and olanzapine for E-selectin and ICAM-1 .  Olanzapine was significantly different after baseline adjustment than perphenazine ( p = .001 ) for E-selectin , and in those with low baseline CRP ( < 1 mg/L ) , olanzapine was significantly different than perphenazine ( p < .001 ) , risperidone ( p < .001 ) , and ziprasidone ( p = .002 ) for CRP .  Perphenazine had the lowest 3-month ICAM-1 levels in subjects with baseline ICAM-1 above the median , but the differences were not statistically significant versus olanzapine ( p = .010 ) , quetiapine ( p = .010 ) , and risperidone ( p = .006 ) after controlling for multiple comparisons . The 18-month repeated measures CRP analysis confirmed the significantly higher values for olanzapine in those with low baseline CRP . CONCLUSIONS This analysis provides further evidence for differential antipsychotic metabolic liabilities as measured by changes in systemic inflammation . C-reactive protein might emerge as a useful target for CV risk outcomes in schizophrenia patients Few pharmacological intervention studies have examined the impact of medication on social cognition , particularly emotion perception . The goal of this r and omized , double-blind study is to compare the effects of several second generation antipsychotics and a first generation antipsychotic , perphenazine , on emotion perception in individuals with schizophrenia . Patients were assigned to receive treatment with olanzapine , queitapine fumarate , risperidone , ziprasidone or perphenazine for up to 18 months . Eight hundred and seventy three patients completed an emotion perception test immediately prior to r and omization and after 2 months of treatment . We also examined baseline predictors of emotion perception change . Most treatments were associated with a small , non-statistically significant improvement in emotion perception at two months , although they did not differ from one another . Greater improvement in emotion perception at 2 months was significantly predicted by lower baseline emotion perception and higher baseline neurocognitive functioning , and marginally predicted by less time on an antipsychotic BACKGROUND One of the major challenges in the design of double-blind flexible-dosing clinical trials comparing active drugs is the selection of dosing regimens that are equivalent across drugs . This study uses data from the CATIE schizophrenia trial to evaluate the hypothesis that drugs that were dosed somewhat higher in the trial than in typical practice would show greater efficacy and more side effects , especially at high capsule levels , than drugs that were dosed at lower relative strengths . METHODS CATIE was a large ( N=1460 ) r and omized trial comparing 5 antipsychotics in patients with chronic schizophrenia . The blind was maintained in CATIE by prescribing identical-looking capsules of each medication . Dosing was flexible , such that PIs could prescribe from one to four capsules per day , and could modify the dose based on a patient 's symptoms and side effects . Capsule strengths for olanzapine ( 7.5 mg ) and quetiapine ( 200 mg ) were relatively higher than for risperidone ( 1.5 mg ) , perphenazine ( 8 mg ) or ziprasidone ( 40 mg ) . Proportional hazards models of time to all cause discontinuation and mixed regression models for continuous measures of symptoms , quality of life and side effects were used to test for interactions between r and omly assigned drug and number of capsules prescribed per visit . We hypothesized that if a dosing bias was present , the flex-dosing design would result in a significant interaction such that drugs with higher relative dosing per capsule would be more effective and have more side effects than drugs with lower relative dosing and that this effect would be greatest at the largest prescribed dosing regimen ( 4 capsules ) . RESULTS There were no significant interactions between drug assignment and number of capsules in the proportional hazards analyses of time to all cause discontinuation ( p=.77 , excluding ziprasidone and .74 in the ziprasidone cohort ) or in the mixed model analysis of PANSS symptoms ( p=.49 ) , quality of life ( p=.45 ) ; or measures of tardive dyskinesia ( AIMS , p=.47 ) . However a significant interaction was observed on the Barnes akathisia scale ( p=.0005 ) , on the Simpson Angus EPS scale ( p=.10 ) and on the analysis of weight ( p=0.014 ) . Paired comparisons did not show the hypothesized pattern of relationships for akathisia or EPS , but such a pattern was suggested for olanzapine in the analysis of weight although it emerged at 2 , 3 and 4 capsules indicating a general drug effect rather than a relative dosing difference . CONCLUSION Dosing biases do not seem to have affected the results of the CATIE trial We compared the efficacy and safety of ziprasidone and aripiprazole in the treatment of acutely ill patients with schizophrenia . Patients were r and omized to receive double-blind treatment with ziprasidone ( 80–160 mg/day ) , or aripiprazole ( 10–30 mg/day ) for up to 4 weeks . Primary efficacy measures were the Clinical Global Impression of Severity scale ( CGI-S ) and Brief Psychiatric Rating Scale ( BPRSd ) total ( derived from the Positive and Negative Syndrome Scale ) . Noninferiority for ziprasidone ( N=125 ) relative to aripiprazole ( N=128 ) was established for CGI-S score ( P=0.007 ) , but was not confirmed for BPRSd total score ( P=0.248 ) . Effect sizes for within-group improvement , however , were robust for both ziprasidone and aripiprazole ( effect size range 1.0–1.1 for CGI-S ; and range 1.1–1.2 for BPRSd total ) . A mixed model repeated measures analysis of BPRSd total score favored ziprasidone at day 4 compared with aripiprazole ( P=0.04 ) , with no significant differences between treatment groups at other visits ( P=0.001 for interaction between treatment and visit ) . No statistically significant difference was found in CGI-S score between groups across all visits . Our findings suggest that ziprasidone and aripiprazole exhibit similar efficacy and tolerability profiles in the treatment of acute schizophrenia . Differences between the two drugs in the onset of therapeutic effect warrant further investigation This 18-week , r and omized , flexible-dose , double-blind , double-dummy trial evaluated ziprasidone as an alternative to clozapine in treatment-refractory schizophrenia patients . Patients had a DSM-IV diagnosis of schizophrenia , a history of resistance and /or intolerance to at least three acute cycles with different antipsychotics given at therapeutic doses , PANSS score > or=80 , and CGI-S score > or=4 . Patients were r and omized to ziprasidone ( 80 - 160 mg/day , n=73 ) or clozapine ( 250 - 600 mg/day , n=74 ) . On the primary ITT-LOCF analysis , baseline-to-endpoint decreases in PANSS total scores were similar in the ziprasidone ( -25.0+/-22.0 , 95 % CI -30.2 to -19.8 ) and clozapine ( -24.5+/-22.5 , 95 % CI -29.7 to -19.2 ) groups . A progressive and significant reduction from baseline in PANSS total score was observed from day 11 in both study arms . There were also significant improvements on PANSS subscales , CGI-S , CG-I , CDSS , and GAF , without between-drug differences . The two treatment groups had similar rates of early discontinuations due to AEs . AEs were mostly of similar mild-moderate severity in the two groups . There were also no detrimental effects on prolactin , renal and liver function , hematology , and cardiovascular parameters . However , ziprasidone but not clozapine showed a significant reduction of SAS and AIMS scores . Moreover , when compared with clozapine , ziprasidone also had a more favorable metabolic profile , with significant endpoint differences in weight , fasting glucose , total cholesterol , LDL cholesterol , and triglycerides . In conclusion , this trial indicates that both ziprasidone and clozapine , having comparable efficacy coupled with satisfactory general safety and tolerability , may be regarded as valuable options for the short-term treatment of difficult-to-treat schizophrenia patients with a history of multiple resistance and /or intolerance to antipsychotics . The more favorable metabolic profile of ziprasidone may represent an added value that could guide clinicians , at least in the presence of patients at high risk for metabolic disorders PURPOSE Previous analysis of data from CATIE showed that patients r and omly assigned to switch to a new medication were more likely to discontinue study drug than those who stayed on the medication they had been taking prior to r and omization . This study addresses additional outcomes measures evaluating symptoms , neurocognition , quality of life , neurological side effects , weight , and health costs . First , considering patients r and omized to olanzapine or risperidone  , outcomes among patients who had been on the drug to which they were r and omized prior to CATIE ( N=129 " stayers " ) were compared to outcomes of those who switched to either of these two drugs ( N=269 " switchers " ) . A second set of analyses considered patients on baseline monotherapy with olanzapine ( N=297 ) ; risperidone ( N=252 ) or quetiapine ( n=87 ) and compared those r and omly assigned to stay on each of these medications with those assigned to switch to any of the other five phase 1 medications in CATIE . In mixed models of each outcome the independent variable of primary interest represented stay vs. switch , with multivariate adjustment for potential confounding factors . RESULTS With one exception , there were no significant differences between stayers and switchers on any outcome measure in either set of analyses . The exception was that , in the second set of analyses , patients who stayed on olanzapine showed greater weight gain than those who switched from olanzapine to other drugs . CONCLUSION Switching to a new medication yielded no advantage over staying on the previous medication . Staying on olanzapine was associated with greater weight gain 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 Violence is an uncommon but significant problem associated with schizophrenia . AIMS To compare antipsychotic medications in reducing violence among patients with schizophrenia over 6 months , identify prospect i ve predictors of violence and examine the impact of medication adherence on reduced violence . METHOD Participants ( n=1445 ) were r and om 
    Output:
    
Ziprasidone may be a slightly less efficacious antipsychotic drug than amisulpride , olanzapine and risperidone .
Its main advantage is the low propensity to induce weight gain and associated adverse effects .