Methods	Allocation: random, no further details. Blindness: double, no further details. Duration: 8 weeks. Design: parallel. Location: multicenter.
Participants	Diagnosis: (DSM-III-R) chronic schizophrenia, non-responders or intolerance, PANSS between 60 and 120. N = 86. Sex: 61 M, 25 F. Age: 18-65 years (mean = 37.3). History: age at first hospitalisation mean clozapine = 25.0, mean risperidone = 26.0, age at onset mean clozapine = 23.5, mean risperidone = 22.4. Setting: inpatient.
Interventions	Clozapine: flexible dose. Allowed dose range: 150-400 mg/day. Mean dose: 291.2 mg/day. N = 43. Risperidone: flexible dose. Allowed dose range: 3-10 mg/day. Mean dose: 6.4 mg/day. N = 43
Outcomes	Leaving the study early: any reason, adverse events, inefficacy. Mental State: PANSS total score, PANSS positive subscore, PANSS negative subscore). Adverse effects: cardiac effects, EPS (akinesia, dystonia, parkinsonism, use ofantiparkin-son medication), prolactin associated side effects (sexual dysfunction), sedation, failing memory, concentration difficulties, nausea, weight gain, laboratory (hematology) Unable to use: Change of weight in kg (no usable data).
Notes
Risk of bias
Bias	Authors’ judgement	Support for judgement
Adequate sequence generation?	Unclear risk	Random, no further details.
Allocation concealment?	Unclear risk	No further details.
Blinding? 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? 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 addressed? All outcomes	Unclear risk	The overall attrition was moderate (20.9%) . The LOCF method was used to account for people leaving the study early. It assumes that a participant who discontinued the study would not have had a change of his condition if he had remained in the study. This assumption can obviously be wrong
Free of selective reporting?	High risk	Secondary outcomes were not fully reported. For treatment emergent adverse events there was an incidence ofat lest 5% occurrence for being reported
Free of other bias?	High risk	The study was sponsored by the manufacturer of risperidone.