***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: Hospital costs for chronic schizophrenic patients consume a major share of the cost of mental health care . Despite the success of numerous community mental health programs , repeated hospital admission of schizophrenic patients is a significant problem . Effective therapy and compliance with that therapy are two important factors in reducing hospitalization . Adverse effects of antipsychotic agents , particularly extrapyramidal symptoms ( EPS ) , negatively influence compliance . A new antipsychotic agent , risperidone , has demonstrated efficacy against both positive and negative symptoms of schizophrenia and has been associated with a low incidence of EPS . To assess the potential of risperidone therapy to reduce the number of days in the hospital , a retrospective analysis was undertaken of data from a year-long clinical trial of risperidone . For 27 patients who had completed 365 days of open-label therapy with risperidone  , the number of hospital days during this period was compared with the number of hospital days in the preceding 365-day period , when the patients were receiving conventional antipsychotic medication . The mean number of hospital days was reduced from 106 to 85 days , for a 20 % reduction ( P = 0.003 ) after the initiation of risperidone . Three subgroups of patients were apparent : ( 1 ) those who had spent no time in the hospital in the pre-risperidone year , ( 2 ) those who had been continuously hospitalized in the pre-risperidone year , and ( 3 ) those who had spent part of the pre-risperidone year ( 3 to 165 days ) in the hospital . A 73 % reduction ( P = 0.0009 ) in mean hospital days ( from 49 to 13 days ) was achieved in the third subgroup ( n = 14 ) . These findings suggest that risperidone may have a role in reducing hospital days for the chronic schizophrenic population A number of studies have reported reduced rehospitalization for patients on clozapine .  This article adds to that literature by mining the clozapine data base at Hillside Hospital . The sample consisted of 81 schizophrenia patients who entered Hillside on a typical neuroleptic and then had their medication changed to clozapine .  We ascertained the number of inpatient hospitalizations before starting clozapine and compared this with the number of hospitalizations after starting clozapine . We also followed an age- and gender-matched comparison group of other schizophrenia patients who entered Hillside at approximately the same time . Results indicate that the mean number of rehospitalizations while on a typical neuroleptic was 2.03 (1.93)/year , whereas it was only .56 ( .97/year after the commencement of clozapine treatment ; t(80 ) = 5.78 , p < .001 . A 95 % confidence interval for the superiority of clozapine over st and ard neuroleptic treatment as measured in rehospitalizations/year is ( 1.0 , 2.0 ) . The decrease in hospitalization rate of .4 (1.6)/year ( pre-index date minus post-index date ) for the comparison group was also statistically significant [ t(80 ) = 2.3 , p < .03 ] ; the 95 % confidence interval for this decrease over time is ( .1 , .8 ) . The pre-post change was much greater for the clozapine patients than comparison patients . A 2 x 2 repeated measures analysis of variance ( ANOVA ) contrasting the comparison group to the clozapine patients both before and after the index date indicates a significant time by group interaction ( F(1.80 ) = 22.35 , p < .001 ) , thus documenting the greater relative decrease in rehospitalization rate in the clozapine group BACKGROUND Amisulpride is a substituted benzamide with high selectivity for dopamine D2 and D3 receptors . The purpose of the study was to evaluate the effect of 100 mg amisulpride in patients with predominantly negative symptoms of schizophrenia . METHOD This was a multi-centre , r and omised , parallel-group , double-blind study . Patients received either amisulpride ( 100 mg/day ) or placebo over a six-month treatment period . RESULTS A total of 141 patients were included , 69 received amisulpride , 72 placebo .  Fifty-eight patients ( 41 % ) had received neuroleptic treatment prior to inclusion . The percentage of amisulpride patients completing the study ( 55 % ) was significantly higher than that with placebo ( 32 % ) , and drop-out rates due to lack of efficacy were 27 % with amisulpride and 47 % with placebo . All efficacy assessment s were statistically in favour of amisulpride compared with placebo . The overall incidence of extrapyramidal symptoms was comparable in both groups ; only five patients started anti-Parkinsonian treatment during the study ( one in the placebo and four in the amisulpride group ) . CONCLUSION Amisulpride is effective in the medium-term treatment schizophrenic patients with predominantly negative symptoms BACKGROUND This study compares medication continuation and regimen compliance with the atypical antipsychotic medication clozapine versus the conventional antipsychotic haloperidol . METHOD Data from a 15-site double-blind , r and omized clinical trial ( N = 423 ) were used to compare patients with DSM-III-R schizophrenia assigned to clozapine or haloperidol in terms of duration of participation while taking the r and omly assigned study drug ( continuation ) and the proportion of prescribed pills that were taken ( compliance ) . Multiple regression analysis was used to determine the relationship of baseline characteristics and measures of clinical change to continuation for the entire sample and for patients assigned to each medication . RESULTS Patients assigned to clozapine continued taking the study drug for a mean of 35.5 weeks as compared with only 27.2 among patients assigned to haloperidol ( F = 4.45 , df = 1,422 ; p = .0001 ) . No differences were found between the groups in the proportion of prescribed pills that were returned at any timepoint . Among patients assigned to haloperidol , poorer continuation was associated with being older and greater continuation with receiving public support . Among patients on clozapine treatment , continuation was poorer among African American patients and greater among patients who showed reduced clinical symptoms and akathisia . Continuation with clozapine was greater even after adjusting for these factors . CONCLUSION Continuation with medication is greater with clozapine than haloperidol and is partly explained by greater symptom improvement and reduced side effects . No differences were found in regimen compliance Sertindole is an atypical antipsychotic that is efficacious in schizophrenia and is associated infrequently with extrapyramidal symptoms ( EPS ) . This study assessed time to treatment failure with 24 mg/day sertindole or 10 mg/day haloperidol in 282 clinical ly stable neuroleptic-responsive out patients with schizophrenia . During a 5-week transition period , patients were r and omized to treatment with sertindole or haloperidol ; other treatments were gradually discontinued . Patients then received treatment through Day 365 . Time to treatment failure was numerically superior in sertindole-treated patients compared with haloperidol-treated patients , although this difference was not statistically significant . Sertindole-treated patients , however , remained free of hospitalization for exacerbation of schizophrenia and remained medically compliant significantly longer than did haloperidol-treated patients . In addition , there were significantly fewer reports of EPS in sertindole-treated patients and sertindole therapy was generally well tolerated . Patients transitioned well from other antipsychotic agents to sertindole . Sertindole appears to be an effective long-term treatment for schizophrenia 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 We describe the design of a multicenter , r and omized clinical trial to compare clinical , quality -of-life , and economic outcomes in patients with schizophrenia or schizoaffective disorder who were treated with risperidone or any of 13 conventional antipsychotic drugs approved for use in the United States . This 1-year trial was design ed to approximate conditions of typical clinical practice : protocol -m and ated care was minimized , and all health services ( including medication ) were provided according to usual community practice s. Measures of interest included changes in psychiatric symptoms , medication side effects , health-related quality of life , satisfaction with drug therapy , therapy switching , rehospitalization for the management of relapse , the use of psychiatric services of all types , and the cost of psychiatric care . We review the rationale for this type of trial and discuss the potential value of such trials in setting policy and in clinical practice Clozapine has long been considered a useful treatment in patients who have schizophrenia with the neuroleptic-induced delayed-onset side effect tardive dyskinesia . We present data in support of the clinical impression using both an animal model of the disorder and dyskinetic patients themselves . Clozapine produces a lower rate of oral dyskinesia in laboratory rats after 6 months of chronic treatment than does haloperidol ( 8.6 + /- 1.3 vs. 13.6 + /- 1.4 vacuous chewing movements every 5 minutes , respectively ) , suggesting a lower propensity to cause tardive dyskinesia . In the human , when clozapine was compared with haloperidol in the treatment of patients with tardive dyskinesia , clozapine produced significantly greater benefit for motor symptoms after 12 months of treatment than did haloperidol ( p < .001 ) . Moreover , the dyskinesia rebound , which occurred equally in both drug groups at the beginning of the study , was sustained in the haloperidol group but lost in the clozapine-treated patients . These data suggest that dyskinetic patients lose their symptoms of tardive dyskinesia , along with dopaminergic hypersensitivity , with long-term clozapine treatment In our study , we examined the effectiveness of clozapine and compared it to the array of medication alternatives typically used in the public sector . Long-term patients in Connecticut 's state hospitals who met Food and Drug Administration criteria for clozapine use were invited to participate in this r and omized open-label study . Participants ( N = 227 ) were followed for 2 years . Compared with usual care , clozapine was associated with significantly greater reductions in side effects , disruptiveness , and hospitalization , but was not more effective in reducing symptoms or improving quality of life . The groups did not differ in likelihood of being discharged ; however , once discharged , clozapine patients were less likely to be readmitted . The results of our study suggest that , compared with the flexible range of medication alternatives available , clozapine is an effective agent . However , at least with this patient population , clozapine did not produce the dramatic improvements is symptomatology or hospital utilization reported in clinical efficacy trials or suggested by mirror-image studies OBJECTIVE To assess the efficacy of quetiapine , a recently introduced second generation antipsychotic medication , in reducing cognitive impairment in patients with schizophrenia . DESIGN Prospect i ve , r and omized , double-blind clinical trial . PATIENTS 25 patients who met the Diagnostic and Statistical Manual of Mental Disorders , fourth edition , ( DSM-IV ) criteria for schizophrenia were recruited from 3 Canadian hospitals . INTERVENTION AND OUTCOME MEASURES After a 48-hour washout period , 25 patients with schizophrenia were r and omly assigned to double-blind treatment with quetiapine or haloperidol for 6 months and evaluated with rating scales for psychotic symptoms , mood and extrapyramidal side effects , as well as st and ardized neuropsychological measures sensitive to 6 cognitive domains : fine motor skill , attention span , verbal reasoning and fluency , visuospatial construction and fluency , executive skills and visuomotor tracking , and immediate recall of verbal and nonverbal material s. The measures were repeated 8 weeks and 6 months after treatment was initiated . RESULTS Quetiapine improved psychosis and mood without inducing extrapyramidal symptoms . Quetiapine also had beneficial effects on cognitive skills , particularly ver 
    Output:
    
The analysis revealed that rates of relapse and overall treatment failure were modestly but significantly lower with the newer drugs .
Whether this advantage was partly mediated by improved adherence to treatment remains unclear .
No significant superiority in terms of fewer dropouts due to adverse events was found for the newer drugs .
Overall , the currently available data suggest that new-generation antipsychotics have the potential to reduce relapse rates .