Methods	Allocation: random, no further details. Blindness: double, no further details. Duration: 12 weeks. Design: parallel. Location: not reported.
Participants	Diagnosis: (DSM-IV) schizophrenia, treatment resistance, persistant positive psychotic symptoms, BPRS total score of 35 or more plus CGI score of 4 or more. N=38. Gender: 30 M, 8 F. Age: 18-65 years (mean fluphenazine=44.2 years, mean quetiapine=43.7 years, mean risperidone=46.3 years). History: duration ill not reported, age at onset not reported. Setting: inpatient.
Interventions	Fluphenazine: flexible dose. Allowed dose range: 10-15 mg/day. Mean dose: 13.2 mg/day. N=13. Quetiapine: flexible dose. Allowed dose range: 300-500 mg/day, Mean dose: 463.6 mg/day. N=12. Risperidone: flexible dose. Allowed dose range: 3-5 mg/day. Mean dose: 4.31 mg/day. N=13
Outcomes	Leaving the study early: any reason, adverse events, inefficacy. Global State: CGI. Mental State: BPRS total score, BPRS positive subscore, BPRS negative subscore. Cognitive functioning: Neuropsychological testing. Quality of life: QLS. Adverse effects: open interviews, EPS (use of antiparkinson medication, SAS), prolactin increase, sexual dysfunction, sedation, weight gain, laboratory (thyroidal hormones) Unable to use- Prolactin increase: no useable data. Sexual dysfunction: no useable data.
Notes
Risk of bias
Item	Authors’ judgement	Description
Adequate sequence generation?	Unclear	Random, no further details.
Allocation concealment?	Unclear	No further details.
Blinding? Subjective outcomes	Unclear	Double, no further details. Whether blinding was successful has not been examined, but both compounds differ quite substantially in side effects. This can be a problem for blinding
Blinding? Objective outcomes	Yes	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	No	Overall attrition was moderate 36%. The analysis was based on mixed effect models. It is unclear whether this statistical method can account for such a relatively high attrition rate
Free of selective reporting?	No	Not all of the predefined adverse effects were reported.
Free of other bias?	Unclear	There was a slight baseline imbalance in terms of mean age and the mean number of previous hospitalisations (14 in the risperidone and 9.7 in the quetiapine group)