Methods	Allocation: random, no further details. Blindness: double, no further details. Duration: eight weeks. Design: parallel. Location: multicentre.
Participants	Diagnosis: (DSM-III-R) schizophrenia (n=260) or schizoaffective disorder (n=36), acute exacerbation, PANSS total score of ≥60. N=296. Age: 18-64 years. Gender: 215 M, 81 F. History: duration of illness not reported, age at onset mean risperidone=24.6 years, mean ziprasidone=25.2 years. Setting: not reported.
Interventions	Risperidone: flexible dose, allowed dose range: 6-10 mg/day, mean dose=7.4 mg/day. N=147. Ziprasidone: flexible dose, allowed dose range: 80-160 mg/day, mean dose=114.2 mg/day. N=149
Outcomes	Leaving the study early: any reason, adverse events, inefficacy. Global State: CGI. Mental State: PANSS total score, PANSS derived BPRS, BPRS positive subscore, PANSS negative subscore, depression MADRS. General functioning: GAF. Adverse effects: open interviews, EPS (akathisia, tremor, use of antiparkinson medication, AIMS, BAS, SAS), cardiac effects (ECG), prolactin-associated side-effects, sedation, weight gain, laboratory (urine, blood chemistry) Unable to use- GAF total score (no usable data). QTc abnormalities in ms (no usable data).
Notes
Risk of bias
Bias	Authors’ judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Random, no further details.
Allocation concealment (selection bias)	Unclear risk	No further details.
Blinding (performance bias and detection bias) Subjective outcomes	Unclear risk	Double, no further details. Whether blinding was successful has not been examined, but the compounds differ quite substantially in side-effects. This can be a problem for blinding
Blinding (performance bias and detection bias) Objective outcomes	Low risk	Objective outcomes such as laboratory measures or death are unlikely to have been much affected by problems of blinding
Incomplete outcome data (attrition bias) All outcomes	High risk	The attrition rate was 33%. The last observation carried forward method was used to account for people leaving the study early. Data on study completers were also available
Selective reporting (reporting bias)	High risk	Reporting on secondary outcomes was incomplete.
Other bias	High risk	The study was sponsored by the manufacturer of ziprasidone.