***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 To examine the effectiveness of switching patients to lurasidone using 3 different dosing strategies . METHOD Adults with DSM-IV-defined schizophrenia or schizoaffective disorder in a nonacute phase of illness were r and omized to 1 of 3 lurasidone dosing regimens for the initial 2 weeks of the study : ( 1 ) 40 mg/d for 2 weeks ; ( 2 ) 40 mg/d for 1 week , increased to 80 mg/d on day 8 for week 2 ( up-titration group ) ; and ( 3 ) 80 mg/d for 2 weeks . Lurasidone was then flexibly dosed ( 40 - 120 mg/d ) for the subsequent 4 weeks of the study . The preswitch antipsychotic agent was tapered by day 7 to 50 % of the original dose and discontinued by the end of week 2 . Subjects were stratified on the basis of whether the primary preswitch antipsychotic medication was classified as " sedating " ( olanzapine or quetiapine ) or " nonsedating " ( all other antipsychotics ) . The primary outcome measure was time to treatment failure , defined as any occurrence of insufficient clinical response , exacerbation of underlying disease , or discontinuation due to an adverse event . The study was conducted from June 2010 to May 2011 . RESULTS Of 240 subjects treated in this study , 86 ( 35.8 % ) were treated with an antecedent sedating antipsychotic , and 154 ( 64.2 % ) were treated with an antecedent nonsedating antipsychotic . Nineteen ( 7.9 % ) of the 240 patients experienced treatment failure . No clinical ly relevant differences were observed when the 3 r and omized switch groups were compared . Treatment failure rates were 10/86 ( 11.6 % ) versus 9/154 ( 5.8 % ) among subjects who had been receiving a preswitch sedating versus nonsedating antipsychotic medication , respectively . Consistent with prior studies of lurasidone , there was no signal for clinical ly relevant adverse changes in body weight , glucose , insulin , lipids , or prolactin ; mean improvements in weight and lipids were observed . Movement disorder rating scales did not demonstrate meaningful changes . The incidence of akathisia as an adverse event was 12.5 % ; only 1 subject ( 0.4 % ) discontinued due to akathisia . CONCLUSIONS Switching patients to lurasidone can be successfully accomplished by starting at 40 mg/d for 2 weeks , or 80 mg/d for 2 weeks , or 40 mg/d for 1 week followed by 80 mg/d the second week . TRIAL REGISTRATION Clinical Trials.gov identifier : NCT01143077 Aripiprazole is a D2 and D3 receptor partial agonist that is unlike other second generation antipsychotics . The effectiveness of aripiprazole with regard to neurocognitive function and its adverse effects is unclear . The present study evaluates the comparative efficacy , effects on neurocognitive function , and adverse effects of aripiprazole and risperidone in the treatment of hospitalized patients with schizophrenia . This double-blind , cross-over study included 23 patients with schizophrenia who were r and omly assigned to be treated first with either aripiprazole or risperidone .  After eight weeks on one medication , the patients were switched to the other medication for eight weeks . The patient assessment included the Positive and Negative Syndrome Scale ( PANSS ) , neurocognitive assessment s , and adverse events including extrapyramidal symptoms , vital signs , electrocardiogram , and clinical laboratory tests . The study findings indicated that psychopathology assessed with the PANSS , extrapyramidal symptoms and other adverse effects did not differ between aripiprazole and risperidone for the subjects remaining in treatment . In the neurocognitive assessment s , the score for disinhibition with aripiprazole was significantly lower than with risperidone ( p < 0.05 ) . In addition , serum prolactin levels were significantly lower with aripiprazole ( p < 0.001 ) . The treatment drop-out rate was higher for patients receiving  aripiprazole  than risperidone . In comparing aripiprazole and risperidone , risperidone is better from the viewpoint of treatment continuation . On the other h and , some adverse effects , such as hyperprolactinemia and disinhibition , are less severe with aripiprazole . Thus , for certain applications , aripiprazole may be a beneficial new treatment option for schizophrenia 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 Rationale The relative effectiveness of the atypical antipsychotic drugs and conventional agents in patients with early-stage schizophrenia has not been comprehensively determined . Objectives The aim of our study was to evaluate the efficacy and safety of seven antipsychotic drugs for the maintenance treatment in patients with early-stage schizophrenia . Methods In a 12-month open-label , prospect i ve observational , multicenter study , 1,133 subjects with schizophrenia or schizophreniform disorder within 5 years of onset were monotherapy with chlorpromazine , sulpiride , clozapine , risperidone , olanzapine , quetiapine , or aripiprazole . The primary measure was the rate of treatment discontinuation for any reason . Secondary outcomes included measures for clinical and functional outcomes and tolerability . Results The percentage of patients discontinued treatment within 12 months was 41.4 % for chlorpromazine , 39.5 % for sulpiride , 36.7 % for clozapine , 40.2 % for risperidone , 39.6 % for olanzapine , 46.9 % for quetiapine , and 40.2 % for aripiprazole , a nonsignificant difference ( p = 0.717 ) ; there were no significant differences among these seven treatments on discontinuation due to relapse , intolerability , patient decision , or nonadherence ( all p values ≥ 0.260 ) . Extrapyramidal symptoms were more prominent in chlorpromazine and sulpiride treatment groups . Anticholinergic side effects were most common with clozapine and chlorpromazine . Weight gain was most common with olanzapine and clozapine . Conclusions The efficacy of seven antipsychotic medications for the maintenance treatment appeared similar in early-stage schizophrenia . With regard to the high dropout rate and side effects , special programs are needed to keep efficacy and safety of antipsychotics maintenance treatment for schizophrenia with early ABSTRACT Objective : The Health Outcomes of a Canadian Community Cohort ( HOCCC ) study is a 1-year prospect i ve observational study of out patients with schizophrenia or related psychotic disorders . The purpose of the study was to compare effectiveness of antipsychotic treatment as measured by 1-year treatment completion rates . Design and methods : Patients ( N = 929 ) were enrolled if in the course of usual clinical practice they switched to a second-generation antipsychotic ( SGA ) . Observational data were collected for up to 1 year . The primary analysis compared 1-year treatment-completion rates for the olanzapine cohort with the other SGA cohort ( quetiapine , risperidone , clozapine ) , using a chi-squared test . Results : Of 929 patients enrolled , 64.8 % ( 516/796 ) of evaluable patients completed 1 year of treatment . There was no statistically significant difference in the proportion of treatment completers between the olanzapine cohort ( 67.4 % , 256/380 ) and the other SGA cohort ( 62.5 % , 260/416 ) . Treatment-completion rates were risperidone 62.0 % ( 127/205 ) , quetiapine 63.7 % ( 123/193 ) and clozapine 55.6 % ( 10/18 ) . Antipsychotic polypharmacy was common . Patients treated with olanzapine or risperidone had significantly higher increases in BMI than quetiapine-treated patients . There were no major differences between olanzapine monotherapy and pooled other SGA monotherapy groups in status of extrapyramidal symptoms from baseline to endpoint . Conclusions : Olanzapine and other SGAs exhibited similar rates of 1-year treatment completion . Further study of medication combinations is needed , given their perceived clinical value , and the high frequency of antipsychotic polypharmacy in clinical practice . Limitations : As most patients received several psychotropics and power was reduced in monotherapy analyses , comparisons between cohorts must be interpreted cautiously . Comparisons between individual antipsychotics were post hoc and not powered a priori . Accuracy and completeness of adverse event information for drugs other than olanzapine is limited Thomas SHL , Drici MD , Hall GC , Crocq MA , Everitt B , Lader MH , Le Jeunne C , Naber D , Priori S , Sturkenboom M , Thibaut F , Peuskens J , Mittoux A , Tanghøj P , Toumi M , Moore ND , Mann RD . Safety of sertindole versus risperidone in schizophrenia : principal results of the sertindole cohort prospect i ve study ( SCoP Abstract Objective : Although the use of innovative drug delivery systems , like orally disintegrating antipsychotic tablets ( ODT ) , may facilitate medication adherence and help reduce the risk of relapse and hospitalization , no information is available about the comparative cost-effectiveness of st and ard oral tablets ( SOT ) vs ODT formulations in the treatment of schizophrenia . This study compared the cost-effectiveness of olanzapine ODT and olanzapine SOT in the usual treatment of out patients with schizophrenia from a US healthcare perspective . The study also compared olanzapine ODT with risperidone and aripiprazole , two other atypical antipsychotics available in both ODT and SOT formulations . Methods : Published medical literature and a clinical expert panel were used to populate a 1-year Monte Carlo Micro-simulation model . The model captures clinical and cost parameters including adherence levels , treatment discontinuation by reason , relapse with and without inpatient hospitalization , quality -adjusted life years ( QALYs ) , treatment-emergent adverse events , healthcare re source utilization , and associated costs . Key outcomes were total annual direct cost per treatment , QALY , and incremental cost-effectiveness ( ICER ) per 1 QALY gained . Results : Based on model projections , olanzapine ODT therapy was more costly ( $ 9808 vs $ 9533 ) , but more effective in terms of a lower hospitalization rate ( 15 % vs 16 % ) and better QALYs ( 0.747 vs 0.733 ) than olanzapine SOT therapy . Olanzapine ODT was more cost-effective than olanzapine SOT ( ICER : $ 19,643 ) , more cost-effective than risperidone SOT therapy ( ICER : $ 39,966 ) , and dominant ( meaning less costly and more effective ) than risperidone ODT and aripiprazole in ODT or SOT formulations . Limitations : Lack of head-to-head r and omized studies comparing the three studied atypical antipsychotics required making input assumptions that need further study . Conclusions : This micro-simulation found that the utilization of olanzapine ODT for the treatment of schizophrenia is predicted to be more cost-effective than any other ODT or SOT formulations of the studied atypical antipsychotic medications Abstract Differences among antipsychotics in effectiveness have turned out to be a topic of increasing research interest , although comparisons between the different second-generation antipsychotics are scarce . From October 2005 to March 2011 , a prospect i ve , r and omized , open-label study comparing the effectiveness of aripiprazole , ziprasidone , and quetiapine in the short-term treatment of first-episode schizophrenia-spectrum disorders was undertaken . Two hundred two patients were r and omly assigned to aripiprazole ( n = 78 ) , ziprasidone ( n = 62 ) , or quetiapine ( n = 62 ) and followed up for 6 weeks . 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 . The overall dropout rate at 6 weeks was small ( 6.4 % ) . The treatment discontinuation rate differed significantly between treatment groups ( aripiprazole , 15 % ; zipras 
    Output:
    
RCTs , which are the primary study type for regulatory su bmi ssions , showed a lack of bias .
Studies aim ed at HTA were not as well performed .
As a group , cross-sectional studies scored poorly for bias , with a primary failure to identify a representative sample .