***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: 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 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 Metabolic symptoms induced by antipsychotic medication have been widely documented but there have been few studies comparing the effect of commonly used atypical antipsychotics on blood glucose and lipids among individuals with first-onset schizophrenia . Methods A total of 150 patients with first-onset schizophrenia were r and omized into three groups and each group was treated with olanzapine , quetiapine , or aripiprazole for eight weeks . Blood glucose and lipids ( including levels of triglyceride , total cholesterol , low-density lipoprotein , and high-density lipoprotein ) were tested at baseline and at the end of the 8 weeks of treatment . Results Fasting blood glucose increased significantly over the 8 weeks in the olanzapine group but not in the quetiapine or aripiprazole groups . Based on a repeated measures analysis of variance , triglyceride levels increased significantly over the 8 weeks of treatment and high-density lipoprotein decreased significantly over the 8 weeks of treatment . The increase in triglyceride in the olanzapine and quetiapine groups was greater than that in the aripiprazole group , and the decrease in high-density lipoprotein was greater in the olanzapine and quetiapine groups than in the aripiprazole groups . Conclusions During the first 8 weeks of treatment of drug-naïve patients with schizophrenia , olanzapine has a greater effect on blood glucose than quetiapine or aripiprazole , and both olanzapine and quetiapine have a greater effect on blood lipids than aripiprazole BACKGROUND This is a secondary analysis of clinical trial data collected in 12 European countries . We examined changes in weight and weight-related quality of life among community patients with schizophrenia treated with aripiprazole ( ARI ) versus st and ard of care ( SOC )  , consisting of other marketed atypical antipsychotics ( olanzapine , quetiapine , and risperidone ) . METHOD Five-hundred and fifty-five patients whose clinical symptoms were not optimally controlled and /or experienced tolerability problems with current medication were r and omized to ARI ( 10 - 30 mg/day ) or SOC .  Weight and weight-related quality of life ( using the IWQOL-Lite ) were assessed at baseline , and weeks 8 , 18 and 26 . R and om regression analysis across all time points using all available data was used to compare groups on changes in weight and IWQOL-Lite . Meaningful change from baseline was also assessed . RESULTS Participants were 59.7 % male , with a mean age of 38.5 years ( SD 10.9 ) and mean baseline body mass index of 27.2 ( SD 5.1 ) . ARI participants lost an average of 1.7 % of baseline weight in comparison to a gain of 2.1 % by SOC participants ( p<0.0001 ) at 26 weeks . ARI participants experienced significantly greater increases in physical function , self-esteem , sexual life , and IWQOL-Lite total score . At 26 weeks , 20.7 % of ARI participants experienced meaningful improvements in IWQOL-Lite score , versus 13.5 % of SOC participants . A clinical ly meaningful change in weight was also associated with a meaningful change in quality of life ( p<0.001 ) . A potential limitation of this study was its funding by a pharmaceutical company . CONCLUSIONS Compared to st and ard of care , patients with schizophrenia treated with aripiprazole experienced decreased weight and improved weight-related quality of life over 26 weeks . These changes were both statistically and clinical ly significant CONTEXT Second-generation ( atypical ) antipsychotics ( SGAs ) are more expensive than first-generation ( typical ) antipsychotics ( FGAs ) but are perceived to be more effective , with fewer adverse effects , and preferable to patients . Most evidence comes from short-term efficacy trials of symptoms . OBJECTIVE To test the hypothesis that in people with schizophrenia requiring a change in treatment , SGAs other than clozapine are associated with improved quality of life across 1 year compared with FGAs . DESIGN A noncommercially funded , pragmatic , multisite , r and omized controlled trial of antipsychotic drug classes , with blind assessment s at 12 , 26 , and 56 weeks using intention-to-treat analysis . SETTING Fourteen community psychiatric services in the English National Health Service . PARTICIPANTS Two hundred twenty-seven people aged 18 to 65 years with DSM-IV schizophrenia and related disorders assessed for medication review because of inadequate response or adverse effects . INTERVENTIONS R and omized prescription of either FGAs or SGAs ( other than clozapine ) , with the choice of individual drug made by the managing psychiatrist . MAIN OUTCOME MEASURES Quality of Life Scale scores , symptoms , adverse effects , participant satisfaction , and costs of care . RESULTS The primary hypothesis of significant improvement in Quality of Life Scale scores during the year after commencement of SGAs vs FGAs was excluded . Participants in the FGA arm showed a trend toward greater improvements in Quality of Life Scale and symptom scores . Participants reported no clear preference for either drug group ; costs were similar . CONCLUSIONS In people with schizophrenia whose medication is changed for clinical reasons , there is no disadvantage across 1 year in terms of quality of life , symptoms , or associated costs of care in using FGAs rather than nonclozapine SGAs . Neither inadequate power nor patterns of drug discontinuation accounted for the result The aim of the present work was to investigate possible differences in terms of efficacy and tolerability between different switching options to aripiprazole .  77 subjects were r and omly assigned to ( 1 ) administration of aripiprazole  ( 10 mg ) with simultaneous discontinuation of current antipsychotic ; ( 2 ) administration of aripiprazole ( 10 mg ) and tapering off current antipsychotic over 4 weeks with half dose after the first 2 weeks ; ( 3 ) administration of aripiprazole ( 10 mg ) and tapering off current antipsychotic over 6 weeks with half dose after the first 2 weeks . Efficacy assessment s included CGI-S , CGI-I , BPRS and SANS . Safety assessment s included SAS , BAS and AIMS . Severity of symptoms significantly decreased from baseline over the 12 weeks of treatment . Patients switched to aripiprazole with immediate discontinuation of the previous antipsychotic showed an increase of symptoms ' severity at week 1 . However , severity of side effects did not overall change significantly during the 12-weeks follow-up . Previous treatment 's tapering off strategy for switching patients to aripiprazole could be preferable as compared to abrupt discontinuation , in order to prevent early worsening of symptoms and premature discontinuation of treatment , though this results has to be considered with caution given the limitations of the study Although recent treatment guidelines for schizophrenia recommend that the prior antipsychotic agent should remain stable for at least 2 weeks when aripiprazole is introduced , there is no trial-based evidence to support this strategy . This study was design ed to compare this strategy with another conventional one in patients with schizophrenia . We conducted a r and omized , 14-week , open-label trial to compare the following 2 switching strategies : ( 1 ) add-on of aripiprazole on a current regimen , wait for 4 weeks , and the tapering of prior antipsychotics and ( 2 ) add-on of aripiprazole and the simultaneous tapering of prior antipsychotics in  patients with schizophrenia .  Aripiprazole was initiated at 12 mg/d and then titrated between 12 and 30 mg . The previous antipsychotic medication was reduced biweekly by 25 % . Assessment s included the Clinical Global Impression Scale Schizophrenia version , the Drug-Induced Extrapyramidal Symptoms Scale , and the Subjective Well-being Under Neuroleptics , Short Version , Japanese Edition . Impressions toward their assigned strategy were also subjectively evaluated at baseline and end point . Fifty-three patients were enrolled , and 48 patients completed this trial . No significant differences were found in changes from the baseline in the total Clinical Global Impression Scale Schizophrenia version severity , Drug-Induced Extrapyramidal Symptoms Scale , and Subjective Well-being Under Neuroleptics , Short Version , Japanese Edition scores throughout the study period between the 2 strategies . Both strategies were judged by subjects to be tolerable and favorable without between-group differences . In conclusion , both strategies were found to be objective ly safe and well tolerated . Taken together with similar results from subjective assessment s , it would be reasonable to choose either of these 2 strategies in clinical practice based on a patients ' preference Abstract Background : The Schizophrenia Trial of Aripiprazole ( STAR ) showed superior efficacy for aripiprazole compared with atypical antipsychotic st and ard-of-care ( SOC ) for the community treatment of schizophrenia1 based on the Investigator Assessment Question naire total score . Objective : To determine the cost-effectiveness of aripiprazole compared with SOC medications from a health and social care system perspective . Methods : Information on health and social care service use was collected using the Client Socio-demographic and Service Receipt Inventory ( CSSRI ) . Unit costs attached to each service were used to calculate patients ’ healthcare and other costs . The primary outcome measure was Investigator ’s Assessment Question naire ( IAQ ) score ; secondary measures included the Clinical Global Impression (CGI)-Improvement response and Quality of Life Scale ( QLS ) . Incremental cost-effectiveness was measured over 26 weeks as the ratio of the difference in mean costs between aripiprazole and SOC ( olanzapine , quetiapine and risperidone ) to the difference in mean outcomes . Net benefit was used to plot the cost-effectiveness acceptability curve . Results : The analysis sample ( all r and omised subjects who met the study inclusion criteria ) included 282 individuals r and omised to aripiprazole and 266 to SOC ( olanzapine , n = 75 ; quetiapine , n = 110 and risperidone , 
    Output:
    
Aripiprazole is an antipsychotic drug with an important adverse effect profile .