***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: In a double-blind comparative trial of sulpiride ( 600 - 1,800 mg/day ) and trifluoperazine ( 15 - 45 mg/day ) in 38 chronic schizophrenic patients , ratings of therapeutic results and unwanted effects were made at two-weekly interviews during the six weeks treatment period . The results show that sulpiride has neuroleptic properties and a spectrum of therapeutic activity similar to that of trifluoperazine . There was an association between plasma sulpiride levels and therapeutic response after four weeks ' treatment 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 Effects of the dopamine antagonist sulpiride on event-related potentials ( ERPs ) were investigated during an auditory odd ball task in 18 healthy volunteers .  Sulpiride ( 150 or 300 mg ) or an inactive placebo was administered according to a completely r and omized double-blind cross-over design . ERPs were recorded 1 h after medication was given . Sulpiride shortened the P200 latency for frequent stimuli , but tended to increase the N200 and P300 latencies for rare stimuli . Although on the whole sulpiride had no effect on the amplitudes of the ERP components in the subjects , it increased the P300 amplitudes in the low P300 amplitude subjects and decreased them in the high P300 amplitude subjects . This tendency for a bidirectional response was also found for the N100 and N200 amplitudes . A single administration of 150 or 300 mg sulpiride is considered to affect the ERP latencies and amplitudes in healthy subjects , the bidirectional response that takes place being dependent on the difference in the initial values . The results of this study are discussed in relation to the ' Law of initial value ' BACKGROUND We hypothesised that a combined regimen of clozapine , a relatively weak D2-dopaminergic antagonist , and sulpiride , a selective D2 blocker , would demonstrate a greater antipsychotic efficacy by enhancing the D2 blockade of clozapine . METHOD Twenty-eight people with schizophrenia , previously unresponsive to typical antipsychotics and only partially responsive to current treatment with clozapine  , received , double-blind , 600 mg/day sulpiride or placebo , in addition to an ongoing clozapine treatment . The clinical status was evaluated before , during , and at the end of 10 weeks of sulpiride addition using the Brief Psychiatric Rating Scale ( BPRS ) , Scale for the Assessment of Positive Symptoms ( SAPS ) , Scale for the Assessment of Negative Symptoms , and Hamilton Rating Scale for Depression . RESULTS The clozapine-sulpiride group exhibited substantially greater and significant improvements in positive and negative psychotic symptoms . About half of them , characterised by a younger age and lower baseline SAPS scores , had a mean reduction of 42.4 and 50.4 % in their BPRS and SAPS scores , respectively . CONCLUSIONS A subgroup of patients with chronic schizophrenia may substantially benefit from sulpiride addition to clozapine The authors estimated components of variance and intraclass correlation coefficients ( ICCs ) to aid in the design of complex surveys and community intervention studies by analyzing data from the Health Survey for Engl and 1994 . This cross-sectional survey of English adults included data on a range of lifestyle risk factors and health outcomes . For the survey , households were sample d in 720 postal code sectors nested within 177 district health authorities and 14 regional health authorities . Study subjects were adults aged 16 years or more .  ICCs and components of variance were estimated from a nested r and om-effects analysis of variance . Results are presented at the district health authority , postal code sector , and household levels . Between-cluster variation was evident at each level of clustering . In these data , ICCs were inversely related to cluster size , but design effects could be substantial when the cluster size was large . Most ICCs were below 0.01 at the district health authority level , and they were mostly below 0.05 at the postal code sector level . At the household level , many ICCs were in the range of 0.0 - 0.3 . These data may provide useful information for the design of epidemiologic studies in which the units sample d or allocated range in size from households to large administrative areas Eleven patients with Huntington 's disease and nine patients with tardive dyskinesia participated in a r and omised double-blind crossover trial of sulpiride ( as sole antidopaminergic therapy ) versus placebo . Although functional improvement was not seen in Huntington 's disease patients , sulpiride reduced movement count and total dyskinesia score in both conditions . Sulpiride differs pharmacologically in several respects from conventional neuroleptics , and has not been convincingly shown to cause tardive dyskinesia . Among currently available treatments , it may therefore be considered a drug of choice for treatment of tardive dyskinesia Tardive dyskinesia can be suppressed by drugs that block dopaminergic receptors , but often at the cost of a concomitant increase in parkinsonism .  Sulpiride ( 400–2100 mg/day ) , a selective type-2 dopamine receptor antagonist , was evaluated in a blind , placebo-controlled trial in 11 patients with tardive dyskinesia . It significantly ( P<0.01 ) reduced tardive dyskinesia without significantly affecting parkinsonism , although three patients had an increase in preexisting parkinsonian hypokinesia and tremor , During the placebo phase , the tardive dyskinesia and parkinsonian scores returned to the pretreatment values . There was no relationship between either tardive dyskinesia or parkinsonism and eye blinking rates . These results are consistent with the hypothesis that more than one population of dopamine receptors are involved in controlling extrapyramidal functions .  Sulpiride is an important tool for elucidating both the practical and heuristic aspects of subtypes of dopamine receptors and is a lead in the search for compounds that selectively affect dopaminergic mechanisms Several recent studies , albeit limited in sample number , design and generalizability , have suggested that augmentation of atypical antipsychotic medication ( such as clozapine and olanzapine ) with sulpiride , a substituted benzamide antipsychotic medication , may play a role in the management of treatment-resistant psychotic conditions . The objective of this study was to investigate any change in clinical symptomatology or side-effect profile in treatment-resistant schizophrenia patients receiving sulpiride in addition to olanzapine . Seventeen patients with treatment-resistant chronic schizophrenia , who were receiving olanzapine monotherapy for at least 6 months before study commencement , were r and omized in a 1 : 1 fashion to receive either adjunctive treatment with sulpiride ( study group ) or to continue their pre- study treatment with olanzapine with no medication augmentation ( control group ) , each for a period of 8 weeks . Changes in measures of positive and negative symptoms , anxiety , depression and extrapyramidal symptoms were assessed at baseline and at 8 weeks . Study observations indicated no significant differences in the changes in positive or negative symptomatology between patients receiving a combined regimen of olanzapine with sulpiride ( 600 mg/day ) augmentation and controls . However , a significantly greater improvement of depressive symptomatology ( P < 0.05 ; as assessed by the Hamilton Scale for Depression ) was noted in the sulpiride augmentation group . These data indicate improvement in depressive symptomatology with sulpiride augmentation of olanzapine in treatment-resistant chronic schizophrenia patients In a material of 71 patients admitted because of acute or chronic psychoses , 32 were treated with  sulpiride  ( up to 1,800 mg per day ) and 39 with  chlorpromazine  ( up to 675 mg ) . Duration of treatment was from 4 to 8 weeks . The effect of the two preparations was very similar as were the type and frequency of side effects , except that sulpiride did not cause sunrash The abnormal involuntary movements in tardive dyskinesia can be reduced by the dopamine antagonist drugs , phenothiazines and butyrophenones , but most cause an increase in Parkinsonian signs .  Sulpiride , a benzamide derivative , and selective antagonist of D2 receptors had a significantly beneficial effect on most of 15 patients ( p less than 0.01 ) . In 12 patients the improvement was marked . The reduction of abnormal movements was observed even with low doses , and it was not necessary to increase the dose of sulpiride above 600 mg daily . There were no significant side effects during the trial nor during an additional three months of treatment BACKGROUND A recent review suggested an association between using unpublished scales in clinical trials and finding significant results . AIMS To determine whether such an association existed in schizophrenia trials . METHOD Three hundred trials were r and omly selected from the Cochrane Schizophrenia Group 's Register . All comparisons between treatment groups and control groups using rating scales  were identified . The publication status of each scale was determined and cl aims of a significant treatment effect were recorded . RESULTS Trials were more likely to report that a treatment was superior to control when an unpublished scale was used to make the comparison ( relative risk 1.37 ( 95 % CI 1.12 - 1.68 ) ) . This effect increased when a ' gold-st and ard ' definition of treatment superiority was applied ( RR 1.94 ( 95 % CI 1.35 - 2.79 ) ) . In non-pharmacological trials , one-third of ' gold-st and ard ' cl aims of treatment superiority would not have been made if published scales had been used . CONCLUSIONS Unpublished scales are a source of bias in schizophrenia trials 
    Output:
    
There were no data for many important outcomes such as global outcomes , service use or adverse effects .