***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 
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    Input: BACKGROUND Long-acting injectable formulations of antipsychotics are treatment alternatives to oral agents . AIMS To assess the efficacy of aripiprazole once-monthly compared with oral aripiprazole for maintenance treatment of schizophrenia . METHOD A 38-week , double-blind , active-controlled , non-inferiority study ; r and omisation ( 2:2:1 ) to aripiprazole once-monthly 400 mg , oral aripiprazole ( 10 - 30 mg/day ) or aripiprazole once-monthly 50 mg ( a dose below the therapeutic threshold for assay sensitivity ) . ( TRIAL REGISTRATION clinical trials.gov , NCT00706654 . ) RESULTS A total of 1118 patients were screened , and 662 responders to oral aripiprazole were r and omised . Kaplan-Meier estimated impending relapse rates at week 26 were 7.12 % for aripiprazole once-monthly 400 mg and 7.76 % for oral aripiprazole . This difference ( -0.64 % , 95 % CI -5.26 to 3.99 ) excluded the predefined non-inferiority margin of 11.5 % . Treatments were superior to aripiprazole once-monthly 50 mg ( 21.80 % , P < or = 0.001 ) . CONCLUSIONS Aripiprazole once-monthly 400 mg was non-inferior to oral aripiprazole , and the reduction in Kaplan-Meier estimated impending relapse rate at week 26 was statistically significant v. aripiprazole once-monthly 50 mg 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 PURPOSE The aim of this longitudinal study was to determine whether the depot formulation of an antipsychotic reduces violence in out patients with schizophrenia as compared to oral administration of the same antipsychotic . METHODS Forty-six previously violent patients with schizophrenia were r and omised to receive treatment with oral or depot zuclopenthixol for 1 year . Clinicians interviewed patients at baseline and every month thereafter to assess treatment adherence . An interviewer blinded to treatment assignments interviewed an informant about any violent behaviour during the previous month . RESULTS Violence during the follow-up year was inversely proportional to treatment adherence , better compliance , and greater reduction of positive symptoms . Lower frequency of violent acts was observed in the depot group . The level of insight at baseline was not significantly associated with violence recidivism . Regardless of route of administration , treatment non-adherence was the best predictor of violence . CONCLUSIONS Some patients with schizophrenia and prior violent behaviour  may benefit from the depot formulation of antipsychotic medication OBJECTIVE Potency equivalents for anti-psychotic drugs are required to guide clinical dosing and for design ing and interpreting research studies . Available dosing guidelines are limited by the methods and data from which they were generated . METHOD With a two-step Delphi method , the authors surveyed a diverse group of international clinical and research experts , seeking consensus regarding antipsychotic dosing . The authors determined median clinical dosing equivalents and recommended starting , target range , and maximum doses for 61 drugs , adjusted for selected clinical circumstances . RESULTS Participants ( N=43 ) from 18 countries provided dosing recommendations regarding treatment of psychotic disorders for 37 oral agents and 14 short-acting and 10 long-acting parenteral agents . With olanzapine 20 mg/day as reference , estimated clinical equivalency ratios of oral agents ranged from 0.025 for sulpiride to 10.0 for trifluperidol . Seventeen patient and treatment characteristics , including age , hepatic and renal function , illness stage and severity , sex , and diagnosis , were associated with dosing modifications . CONCLUSIONS In the absence of adequate prospect i ve , r and omized drug-drug comparisons , the present findings provide broad , international , expert consensus-based recommendations for most clinical ly employed antipsychotic drugs . They can support clinical practice , trial design , and interpretation of comparative antipsychotic trials A double-blind cross-over trial comparing oral fluphenazine and fluphenazine enanthate in 43 chronic in-patient male schizophrenics showed that both were efficacious . On the total score assessment  fluphenazine was statistically superior to fluphenazine enanthate , but the overall clinical impression showed a slight superiority for fluphenazine enanthate . Fewer patients needed anti-parkinson medication during the trial period . Patients were as adequately controlled as they had been before the trial on a variety of phenothiazines . The results are discussed , and important factors , such as the certainty that the patients are receiving their medication with the long-acting injection and the saving of time for overworked nursing staff , are stressed IMPORTANCE Long-acting , injectable , second-generation antipsychotic medication has tremendous potential to bring clinical stability to persons with schizophrenia . However , long-acting medications are rarely used following a first episode of schizophrenia . OBJECTIVE To compare the clinical efficacy of the long-acting injectable formulation of risperidone with the oral formulation in the early course of schizophrenia . DESIGN , SETTING , AND PARTICIPANTS A r and omized clinical trial performed at a university-based research clinic , between 2005 and 2012 . Eighty-six patients with recent onset of schizophrenia were r and omized to receive long-acting injectable risperidone or oral risperidone . Half of each group was simultaneously r and omized to receive cognitive remediation to improve cognitive functioning or healthy-behaviors training to improve lifestyle habits and well-being . An intent-to-treat analysis was performed between October 4 , 2012 , and November 12 , 2014 . INTERVENTIONS A 12-month trial comparing the long-acting injectable vs oral risperidone and cognitive remediation vs healthy-behaviors training . MAIN OUTCOMES AND MEASURES Psychotic relapse and control of breakthrough psychotic symptoms . RESULTS Of the 86 patients r and omized , 3 refused treatment in the long-acting injectable risperidone group . The psychotic exacerbation and /or relapse rate was lower for the long-acting risperidone group compared with the oral group ( 5 % vs 33 % ; χ21 = 11.1 ; P < .001 ; relative risk reduction , 84.7 % ) . Long-acting injectable risperidone better controlled mean levels of hallucinations and delusions throughout follow-up ( β = -0.30 ; t68 = -2.6 , P = .01 ) . The cognitive remediation and healthy-behaviors training groups did not differ significantly regarding psychotic relapse , psychotic symptom control , or hospitalization rates , and there were no significant interactions between the 2 medications and the 2 psychosocial treatments . Discontinuations owing to inadequate clinical response were more common in the oral group than in the long-acting risperidone group ( χ21 = 6.1 ; P = .01 ) . Adherence to oral risperidone did not appear to differ before r and omization but was better for the long-acting risperidone group compared with the oral group ( t80 = 5.3 ; P < .001 ) . Medication adherence was associated with prevention of exacerbation and /or relapse ( χ21 = 11.1 ; P = .003 ) and control of breakthrough psychotic symptoms ( β = 0.2 ; t79 = 2.1 ; P = .04 ) . CONCLUSIONS AND RELEVANCE The use of long-acting injectable risperidone after a first episode of schizophrenia has notable advantages for clinical outcomes . The key clinical advantages are apparently owing to the more consistent administration of the long-acting injectable . Such formulations should be offered earlier in the course of illness . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00333177 Long-acting injectable antipsychotics ( LAIs ) should offer better efficacy and tolerability , compared to oral antipsychotics due to improved adherence and more stable pharmacokinetics . However , data on LAIs has been mixed , with some studies finding that they are more effective and tolerable than oral antipsychotics , and others finding the contrary . One possibility for the disparate results may be that some studies administered different antipsychotics in the oral and injectable form . The present systematic review examined the efficacy and tolerability of LAIs versus their oral equivalents in r and omized and naturalistic studies . In addition , it examined the impact of LAIs  on special population s such as patients with first-episode psychosis , substance use disorders , and a history of violence or on involuntary outpatient commitment . R and omized studies suggest that not all LAIs are the same ; for example , long-acting risperidone may be associated with equal or less side effects than oral risperidone , whereas fluphenazine decanoate and enanthate may be associated with equal or more side effects than oral fluphenazine . They also suggest that LAIs reduce risk of relapse versus oral antipsychotics in schizophrenia out patients when combined with quality psychosocial interventions . For their part , naturalistic studies point to a larger magnitude of benefit for LAIs , relative to their oral equivalents particularly among first-episode patients OBJECTIVES The aim of the study was to assess whether the well-tolerated serotonin re-uptake inhibitor paroxetine hydrochloride could prevent vasovagal syncope in young patients resistant to or intolerant of previous traditional therapies . BACKGROUND Serotonergic mechanisms may play a major role in the pathophysiology of neurocardiogenic syncope , and serotonin re-uptake inhibitors have been recently reported to be effective in preventing episodes . METHODS Forty-one consecutive young patients ( 13 male and 28 female ) , aged less than thirty years with recurrent syncope and positive head-up tilt test , and in whom st and ard therapies with beta-blocking , vagolytic , negative inotropic or mineral corticoid agents were ineffectual , poorly tolerated or contraindicated , r and omly received either paroxetine at 20 mg once a day or a placebo . A head-up tilt test was then re-performed after one month of treatment , and the clinical effect was noted over a mean follow-up of 27.1 + /- 6.6 months . RESULTS The response rates ( negative tilt test ) after one month of treatment were 57.1 versus 33.3 % ( p < 0.001 ) in the paroxetine and placebo groups , respectively . During follow-up , spontaneous syncope was observed in 4 patients ( 19 % ) in the paroxetine group and in 12 patients ( 60 % ) in the placebo group ( p < 0.001 ) . Only one patient ( 4.8 % ) asked to be discontinued from the drug for severe recurrent headache . CONCLUSIONS Paroxetine significantly improved symptoms of young patients with recurrent vasovagal syncope unresponsive to or intolerant of traditional medications and was well tolerated by patients OBJECTIVE Previous studies showed clinical benefit of risperidone long-acting injection in the treatment of schizophrenia . However , the equivalent switching dose from oral risperidone to risperidone long-acting injection was still in debate . This study , conducted among hospitalized patients , included a long-enough study period and optimal control of drug compliance to test the equivalent switching dose . METHOD Fifty symptomatic , stable hospitalized patients with DSM-IV schizophrenia were r and omly assigned to receive either daily oral risperidone or risper 
    Output:
    
Similarly , no differences emerged in terms of dropouts for adverse events , extrapyramidal symptoms , prolactin increase ( except for a small advantage for LAI risperidone ) , weight gain , non-response rate , relapse rate , and dropouts for inefficacy ( except for a small advantage for oral olanzapine ) .
In conclusion , there is no robust evidence to support doctors in choosing LAI instead of oral formulations in order to obtain better tolerability and efficacy