TABLE 3.
Comparison of Anticholinergic Use Between Antipsychotics and Placebo in the Acute Treatment of Schizophrenia, Mania, or Bipolar Depression
| Agents and Trials | Treatment Arms | Duration, wk | Anticholinergic Use
|
||
|---|---|---|---|---|---|
| No. Patients | ARR or ARI, % | NNTB or NNTH | |||
|
| |||||
| Mean (95% CI) | Mean (95% CI) | ||||
| Antipsychotics in schizophrenia | |||||
| Haloperidol | |||||
| Kane et al20 | HAL 8–12 mg/d (n = 222) | 4–8 | 56 | −23.4 (−31.3 to −15.2) | −4 (−7 to −3)* |
| Arvanitis et al21 | PBO (n = 228) | 19 | |||
| Zimbroff et al22 | |||||
| Aripiprazole | |||||
| Kane et al20 | ARIP 30 mg/d (n = 101) | 4 | 15 | −3.3 (−12.8 to 6.1) | −30 (16 to −8) |
| PBO (n = 104) | 12 | ||||
| Kane et al20 | ARIP 15 mg/d (n = 101) | 4 | 8 | 3.6 (−4.8 to 12.1) | 28 (8 to −21) |
| PBO (n = 104) | 12 | ||||
| Olanzapine | |||||
| Beasley et al24 | OLZ 12–16 mg/d (n = 133) | 6 | 33 | −13.1 (−22.8 to −1.28) | −8 (−78 to −4)* |
| PBO (n = 68) | 8 | ||||
| Quetiapine | |||||
| Arvanitis et al21 | QTP 600 mg/d (n = 51) | 6 | 6 | 2.0 (−11.6 to 15.5) | 51 (6 to −9) |
| PBO (n = 51) | 7 | ||||
| Risperidone | |||||
| Chouinard et al25 | RIS 6 mg/d (n = 86) | 4–8 | 20 | −2.8 (−15.0 to 9.5) | −36 (11 to −7) |
| Marder et al26 | PBO (n = 88) | 18 | |||
| Ziprasidone | |||||
| Keck et al27 | ZIP 120–160 mg/d (n = 151) | 4–6 | 35 | −11.8 (−20.3 to −3.0) | −9 (−33 to −5)* |
| Daniel et al28 | PBO (n = 140) | 16 | |||
| Antipsychotics in bipolar mania | |||||
| Haloperidol | |||||
| McIntyre et al29 | HAL 2–8 mg/d (n = 99) | 3 | 52 | −40.6 (−51.4 to −28.2) | −2 (−4 to −2)* |
| PBO (n = 101) | 12 | ||||
| Quetiapine | |||||
| Vieta et al32 | QTP ≈ 600 mg/d (n = 208) | 12 | 21 | 0 (−5.9 to 6.1) | 1881 (16 to −17) |
| PBO (n = 195) | 20 | ||||
| Risperidone | |||||
| Hirschfeld et al36 | RIS 4.1–5.6 mg/d (n = 280) | 3 | 82 | −20.7 (−27.0 to −14.4) | −5 (−7 to −4)* |
| Khanna et al37 | PBO (n = 269) | 23 | |||
| Ziprasidone | |||||
| Potkin et al39 | ZIP 112–147 mg/d (n = 136) | 3 | 35 | −19.1 (−27.8 to −8.4) | −5 (−12 to −4)* |
| PBO (n = 66) | 4 | ||||
| Antipsychotics in bipolar depression | |||||
| Olanzapine | |||||
| Tohen et al43 | OLZ 9.7 mg/d (n = 351) | 8 | 12 | 0.6 (2.3 to −3.4) | −177 (46 to −30) |
| PBO (n = 355) | 14 | ||||
*
Significant difference from placebo at α = 0.05 level.
ARI indicates absolute risk increase; ARIP, aripiprazole; ARR, absolute risk reduction; CI, confidence interval; HAL, haloperidol; NNTB, number needed to treat to benefit; NNTH, number needed to treat harm; OLZ, olanzapine; PBO, placebo; QTP, quetiapine; RIS, risperidone; ZIP, ziprasidone.