***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 Antipsychotics , such as aripiprazole and risperidone , are often used to treat individuals with schizophrenia . The efficacy as well as safety of aripiprazole in Western population s has been described . The objective of this study is to investigate the efficacy , safety , and tolerability of aripiprazole and risperidone in Chinese Han schizophrenia subjects in mainl and China . METHOD The 6-week , double-blind , r and omized , parallel study was conducted in 5 medical centers in mainl and China from November 2007 to March 2011 . A total of 279 subjects with a primary DSM-IV diagnosis of schizophrenia were r and omly assigned ( with a r and omization ratio of 1:1 ) to aripiprazole ( n=139 ) or risperidone ( n=140 ) . Efficacy measurements included the Positive and Negative Syndrome Scale ( PANSS ) total , positive , negative and general psychopathology subscale scores , and Clinical Global Impressions-Severity of Illness ( CGI-S ) , and Improvement scale scores . Extrapyramidal symptoms ( EPS ) , weight gain , serum prolactin level , QTc interval , and self-reported adverse events were also assessed as measures of safety and tolerability . RESULTS Both the aripiprazole and risperidone groups showed statistically significant improvement of PANSS total , positive , negative , general psychopathology subscale scores , and CGI-S scores from baseline to the endpoint ( all p<0.01 ) . Significant improvement was noted in the first week for both treatment groups . There were no significant differences in efficacy measurements between the two treatment groups . Mean change of PANSS total scores from baseline to the endpoint was -26.8±18.1 for aripiprazole and -30.0±17.7 for risperidone , ( p=0.1475 ) . The responder rate was 71 % ( n=99 ) and 76 % ( n=107 ) for aripiprazole and risperidone , respectively , ( p=0.323 ) . The incidences of EPS were similar in the aripiprazole ( 25 % , n=35 ) and risperidone groups ( 24 % , n=34 ) , respectively ( p=0.757 ) . No clinical ly meaningful effects on QTc interval , QRS duration , or PR interval were observed in either treatment groups . However , the incidence of clinical ly significant weight gain ( p=0.0118 ) and hyperprolactinemia ( p<0.001 ) in the aripiprazole group was significantly lower than in the risperidone group . CONCLUSION The study demonstrated that aripiprazole , as well as risperidone , had rapid and persistent efficacy for psychotic symptoms from the first week of therapy . There may be poor efficacy for aripiprazole compared with risperidone for overall improvement , but there were no significant differences in this study . Aripiprazole showed good tolerability with less weight gain and hyperprolactinemia compared with risperidone . The overall efficacy and safety of aripiprazole in Chinese Han schizophrenia subjects were similar to that reported in Western population OBJECTIVE The objective of this multicenter , international study was to evaluate safety and tolerability of paliperidone extended-release ( ER ) tablets in elderly ( age > or = 65 years ) patients with schizophrenia . The authors conducted a 6-week , double-blind , r and omized , placebo-controlled , optional 24-week open-label extension study . Interventions consisted of flexible , once-daily doses of paliperidone ER ( 3 - 12 mg/day ; 6-mg starting dose , adjusted in 3-mg dose increments ) or placebo ( 2:1 ) during double-blind treatment and paliperidone ER only during open-label treatment . Measurements included adverse events , laboratory tests , physical examinations , 12-lead electrocardiograms , movement disorder rating scales , Positive and Negative Syndrome Scale , and Clinical Global Impression scale . The study was not powered to show statistical differences . RESULTS Patients ( N = 114 ) were predominantly female ( 73 % ) ; mean age was 70 years ( double-blind phase ) . Concomitant disease presence was consistent with that of an older population . During the double-blind phase , discontinuation rates result ing from adverse events were similar between groups ( paliperidone ER : 7 % , placebo : 8 % ) as were incidences of treatment-emergent adverse events  ( paliperidone ER : 67 % , placebo : 71 % ) . Serious adverse events occurred in 3 % of the paliperidone ER- and 8 % of the placebo-treated patients . Elevated prolactin levels occurred in approximately one half of patients . No prolactin- or glucose treatment-related adverse events or noteworthy mean changes in body weight ( 0 kg [ st and ard deviation : 2.1 ] and 0 kg [ st and ard deviation : 2.3 ] for paliperidone ER and placebo , respectively ) were observed . Safety and tolerability results in the extension were consistent with the shorter-term results . Efficacy measures did not show consistent statistical improvement between treatment groups . CONCLUSION Paliperidone ER ( 3 - 12 mg/day ) treatment over a 30-week period was generally well-tolerated and may improve symptom severity in elderly patients with schizophrenia OBJECTIVE To evaluate aripiprazole once-monthly ( AOM ) , a long-acting injectable suspension of aripiprazole , as acute treatment in patients with schizophrenia ( DSM-IV-TR ) . METHOD Adults experiencing an acute psychotic episode were r and omized to 12 weeks of double-blind treatment with  AOM 400 mg or placebo ( October 2012-August 2013 ) . The primary efficacy outcome was change from baseline to endpoint ( week 10 ) in Positive and Negative Syndrome Scale ( PANSS ) total score . The key secondary efficacy outcome was change from baseline in Clinical Global Impressions-Severity of Illness scale ( CGI-S ) score . Secondary efficacy outcomes included change from baseline in PANSS positive and negative subscale and Personal and Social Performance Scale ( PSP ) scores . The study took place from October 2012 through August 2013 . RESULTS Patients ( N = 340 ; 79 % male , 66 % black ) were r and omized to AOM ( n = 168 ) or placebo ( n = 172 ) . Least squares ( LS ) mean change from baseline to endpoint ( week 10 ) favored AOM versus placebo in PANSS total ( treatment difference , -15.1 [ 95 % CI , -19.4 to -10.8 ] ; P < .0001 ) and CGI-S ( treatment difference , -0.8 [ 95 % CI , -1.1 to -0.6 ] ; P < .0001 ) scores , as it did at all other timepoints through 12 weeks ( all P ≤ .0005 ) . LS mean change from baseline in PANSS positive and negative subscale and PSP scores favored AOM versus placebo ( P < .0001 ) . Common ( > 10 % ) treatment-emergent adverse events  ( AOM vs. placebo ) were increased weight ( 16.8 % vs 7.0 % ) , headache ( 14.4 % vs. 16.3 % ) , and akathisia ( 11.4 % vs 3.5 % ) . CONCLUSIONS Symptoms and functioning improved with AOM 400 mg versus placebo in patients with acute schizophrenia , with acceptable safety and tolerability . These data suggest that AOM 400 mg is a viable treatment option for patients experiencing an acute schizophrenia episode . TRIAL REGISTRATION Clinical Trials.gov identifier : NCT01663532 OBJECTIVE The efficacy , safety , and tolerability of brexpiprazole and placebo were compared in adults with acute schizophrenia . METHOD This was a multicenter , r and omized , double-blind , placebo-controlled study . Patients with schizophrenia experiencing an acute exacerbation were r and omly assigned to daily brexpiprazole at a dosage of 0.25 , 2 , or 4 mg or placebo ( 1:2:2:2 ) for 6 weeks . Outcomes included change from baseline to week 6 in Positive and Negative Syndrome Scale ( PANSS ) total score ( primary endpoint measure ) , Clinical Global Impressions Scale ( CGI ) severity score ( key secondary endpoint measure ) , and other efficacy and tolerability measures . RESULTS The baseline overall mean PANSS total score was 95.2 , and the CGI severity score was 4.9 . Study completion rates were 62.2 % , 68.1 % , and 67.2 % for patients in the 0.25- , 2- , and 4-mg brexpiprazole groups , respectively , versus 59.2 % in the placebo group . At week 6 , compared with placebo , brexpiprazole dosages of 2 and 4 mg produced statistically significantly greater reductions in PANSS total score ( treatment differences : -8.72 and -7.64 , respectively ) and CGI severity score ( treatment differences : -0.33 and -0.38 ) . The most common treatment-emergent adverse event for brexpiprazole was akathisia ( 2 mg : 4.4 % ; 4 mg : 7.2 % ; placebo : 2.2 % ) . Weight gain with brexpiprazole was moderate ( 1.45 and 1.28 kg for 2 and 4 mg , respectively , versus 0.42 kg for placebo at week 6 ) . There were no clinical ly or statistically significant changes from baseline in lipid and glucose levels and extrapyramidal symptom ratings . CONCLUSIONS Brexpiprazole at dosages of 2 and 4 mg/day demonstrated statistically significant efficacy compared with placebo and good tolerability for patients with an acute schizophrenia exacerbation Objective : The objective of this study was to evaluate the short-term efficacy and safety of the atypical antipsychotic agent lurasidone in the treatment of schizophrenia . Methods : In this phase II , r and omized , double-blind , placebo-controlled study , hospitalized adult patients diagnosed with schizophrenia and experiencing an acute exacerbation of psychotic symptoms were r and omly assigned to 6 weeks of fixed-dose lurasidone 20 mg/day ( n = 71 ) , lurasidone 40 mg/day ( n = 67 ) , lurasidone 80 mg/day ( n = 71 ) , haloperidol 10 mg/day ( n = 72 , included to test for assay sensitivity ) , or placebo ( n = 72 ) . Efficacy was assessed using the brief psychiatric rating scale , positive and negative syndrome scale , and clinical global impression-severity . Safety assessment s included incidence of adverse events and clinical laboratory measures . Results : Numerical improvement was observed from baseline to week 6 ( last observation carried forward ) on all efficacy measures in all treatment groups ; however , no statistically significant differences were noted between any lurasidone group and placebo , or between haloperidol and placebo . The most common adverse events in lurasidone-treated patients , with an incidence of at least 10 % ( dose groups combined ) and greater than placebo , were sedation ( 15.3 % ) , dyspepsia ( 13.4 % ) , nausea ( 13.4 % ) , akathisia ( 12.4 % ) , and vomiting ( 10.5 % ) ; for haloperidol , the most common adverse events ( incidence ⩾ 10 % and greater than placebo ) were extrapyramidal disorder ( 20.8 % ) , sedation ( 19.4 % ) , akathisia ( 19.4 % ) , dystonia ( 15.3 % ) , insomnia ( 13.9 % ) , and somnolence ( 12.5 % ) . Lurasidone was associated with minimal changes in weight , metabolic parameters , and prolactin levels . Conclusions : None of the lurasidone groups separated from placebo in this clinical study of patients with acute schizophrenia . In addition , haloperidol , which was included for assay sensitivity , did not separate from placebo , result ing in a failed study . Possible reasons for the lack of assay sensitivity in this study include the use of multiple active treatment arms and the relatively large placebo response . Consistent with other studies , lurasidone was generally safe and well tolerated , with minimal effects on weight or metabolic parameters Paliperidone palmitate is a long-acting injectable antipsychotic agent . This 13-week , multicenter , r and omized ( 1 : 1 : 1 : 1 ) , double-blind , parallel-group study evaluated the efficacy , safety , and tolerability of fixed 25 , 50 , and 100 milligram equivalent ( mg equiv . ) doses of paliperidone palmitate vs placebo administered as gluteal injections on days 1 and 8 , then every 4 weeks ( days 36 and 64 ) in 518 adult patients with schizophrenia . The intent-to-treat analysis set ( N=514 ) was 67 % men and 67 % White , with a mean age of 41 years . All paliperidone palmitate dose groups showed significant improvement vs placebo in the Positive and Negative Syndrome Sc 
    Output:
    
Interpretation Marked differences exist between antipsychotics in terms of metabolic side-effects , with olanzapine and clozapine exhibiting the worst profiles and aripiprazole , brexpiprazole , cariprazine , lurasidone , and ziprasidone the most benign profiles .
Increased baseline weight , male sex , and non-white ethnicity are predictors of susceptibility to antipsychotic-induced metabolic change , and improvements in psychopathology are associated with metabolic disturbance .