A. Butler

A placebo-controlled comparison of zotepine versus chlorpromazine in patients with acute exacerbation of schizophrenia

Objective:The aim was to evaluate the efficacy of zotepine in the treatment of acute episodes of schizophrenia.

The efficacy of zotepine in schizophrenia: A meta-analysis of BPRS and improvement scale scores

OBJECT: To assess the efficacy of the antipsychotic drug zotepine in the treatment of the global psychopathology of schizophrenia. METHOD: Fifteen randomized placebo- or antipsychotic comparator- controlled trials were analysed, using the Brief Psychiatric Rating Scale (BPRS) or other improvement scales. A meta-analysis of standardized treatment differences and a test for homogeneity were performed on four comparator groups: all placebo-controlled trials, all antipsychotic comparator-controlled trials, conventional antipsychotic comparator-controlled trials, and antipsychotic comparator-controlled trials excluding those in which the dosage for zotepine exceeded 75-300 mg/day (the recommended dose in the UK). The outcome measure used in the meta-analysis was the change in rating score. RESULTS: Meta-analysis of the placebo-controlled trials showed that a significantly greater reduction in BPRS occurred with zotepine therapy than with placebo therapy. The reduction in rating score was also greater with zotepine therapy than with antipsychotic comparators. Exclusion of the high-dose zotepine studies did not alter these conclusions. Only in one trial, in which zotepine was compared with the atypical antipsychotic clozapine, was there a greater reduction in rating score with the comparator than with zotepine (not statistically significant). All tests of homogeneity failed to reach significance, demonstrating that the data were not influenced by inter-study heterogeneity. CONCLUSION: Zotepine is at least as effective against all psychopathological symptoms of schizophrenia as conventional antipsychotics. (Int J Psych Clin Pract 2000; 4:19-27)OBJECT To assess the efficacy of the antipsychotic drug zotepine in the treatment of the global psychopathology of schizophrenia. METHOD Fifteen randomized placebo- or antipsychotic comparator- controlled trials were analysed, using the Brief Psychiatric Rating Scale (BPRS) or other improvement scales. A meta-analysis of standardized treatment differences and a test for homogeneity were performed on four comparator groups: all placebo-controlled trials, all antipsychotic comparator-controlled trials, conventional antipsychotic comparator-controlled trials, and antipsychotic comparator-controlled trials excluding those in which the dosage for zotepine exceeded 75-300 mg/day (the recommended dose in the UK). The outcome measure used in the meta-analysis was the change in rating score. RESULTS Meta-analysis of the placebo-controlled trials showed that a significantly greater reduction in BPRS occurred with zotepine therapy than with placebo therapy. The reduction in rating score was also greater with zotepine therapy than with antipsychotic comparators. Exclusion of the high-dose zotepine studies did not alter these conclusions. Only in one trial, in which zotepine was compared with the atypical antipsychotic clozapine, was there a greater reduction in rating score with the comparator than with zotepine (not statistically significant). All tests of homogeneity failed to reach significance, demonstrating that the data were not influenced by inter-study heterogeneity. CONCLUSION Zotepine is at least as effective against all psychopathological symptoms of schizophrenia as conventional antipsychotics. (Int J Psych Clin Pract 2000; 4:19-27).OBJECT: To assess the efficacy of the antipsychotic drug zotepine in the treatment of the global psychopathology of schizophrenia. METHOD: Fifteen randomized placebo- or antipsychotic comparator- controlled trials were analysed, using the Brief Psychiatric Rating Scale (BPRS) or other improvement scales. A meta-analysis of standardized treatment differences and a test for homogeneity were performed on four comparator groups: all placebo-controlled trials, all antipsychotic comparator-controlled trials, conventional antipsychotic comparator-controlled trials, and antipsychotic comparator-controlled trials excluding those in which the dosage for zotepine exceeded 75-300 mg/day (the recommended dose in the UK). The outcome measure used in the meta-analysis was the change in rating score. RESULTS: Meta-analysis of the placebo-controlled trials showed that a significantly greater reduction in BPRS occurred with zotepine therapy than with placebo therapy. The reduction in rating score was also greater with zote...

The safety and efficacy of zotepine in the treatment of schizophrenia: Results of a one-year naturalistic clinical trial

INTRODUCTION AND METHOD: The safety and efficacy of zotepine,75 - 450 mg/day, were evaluated in an open multicentre one-year study in patients suffering from acute exacerbation of schizophrenia; total exposure amounted to 152.78 years. RESULTS: Mean BPRS total score was reduced from 51.7 at baseline to 40.8 at end-point (P<0.05). Similar significant reductions at all study time-points were recorded for BPRS total and subscores, CGI severity and improvement, BAS total scores and SANS total and global scores. Significant improvements in EPMS and AIMS were recorded from week 12 to end-point. Clinically significant improvements in acute symptoms, detected early in the study, were maintained to end-point. CONCLUSION: Zotepine was well tolerated: weight gain, reduced serum uric acid, raised liver enzymes and increased heart rate were associated with chronic zotepine treatment. Seven patients experienced seizures during the study, although concomitant medications and a known historical predisposition to seizure are factors likely to have contributed to these events. The improvements in negative symptoms and low propensity to cause further extrapyramidal side-effects support the importance of zotepine in maintenance treatment.