Comparison 1. RISPERIDONE vs TYPICAL NEUROLEPTIC MEDICATION.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Global state: 1. Not improved to a clinically important degree (using BPRS)	2		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
1.1 short‐term (up to 12 weeks)	2	173	Risk Ratio (M‐H, Fixed, 95% CI)	0.80 [0.63, 1.02]
2 Global state: 2. Not improved to a clinically important degree (using CGI)	8	1126	Peto Odds Ratio (Peto, Fixed, 95% CI)	0.78 [0.61, 1.00]
2.1 short‐term (up to 12 weeks)	8	1126	Peto Odds Ratio (Peto, Fixed, 95% CI)	0.78 [0.61, 1.00]
3 Global state: 3. Not improved to a clinically important degree (no greater than 20% change in PANSS score)	11	3227	Risk Ratio (M‐H, Fixed, 95% CI)	0.80 [0.74, 0.87]
3.1 short‐term (up to 12 weeks)	9	2368	Risk Ratio (M‐H, Fixed, 95% CI)	0.85 [0.77, 0.93]
3.2 long‐term (over 26 weeks)	2	859	Risk Ratio (M‐H, Fixed, 95% CI)	0.73 [0.65, 0.83]
4 Global state: 4. Not improved to a clinically important degree (no greater than 40% change in PANSS score)	2		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
4.1 short‐term (up to 12 weeks)	1	183	Risk Ratio (M‐H, Fixed, 95% CI)	0.85 [0.60, 1.21]
4.2 long‐term (over 26 weeks)	1	675	Risk Ratio (M‐H, Fixed, 95% CI)	0.75 [0.66, 0.84]
5 Global state: 5. Not improved to a clinically important degree (no greater than 60% chnage in PANSS score)	1		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
5.3 long‐term (over 26 weeks)	1	675	Risk Ratio (M‐H, Fixed, 95% CI)	0.90 [0.84, 0.96]
6 Global state: 6. Not improved to a clinically important degree (as rated by participants)	1	67	Risk Ratio (M‐H, Fixed, 95% CI)	0.72 [0.47, 1.09]
6.1 short‐term (up to 12 weeks)	1	67	Risk Ratio (M‐H, Fixed, 95% CI)	0.72 [0.47, 1.09]
7 Global state: 7a. Relapse ‐ by 1 year	1	367	Risk Ratio (M‐H, Fixed, 95% CI)	0.64 [0.41, 0.99]
8 Global state: 7b. Relapse ‐ average number of days to relapse (skewed data)			Other data	No numeric data
9 Global state: 6. Unable to be discharged from hospital by 8 weeks	1	62	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.65, 1.76]
10 Global state: 6. Change in CGI (continuous, high score = poor)*	4	503	Mean Difference (IV, Fixed, 95% CI)	‐0.11 [‐0.33, 0.11]
10.1 short‐term (up to 12 weeks)	4	503	Mean Difference (IV, Fixed, 95% CI)	‐0.11 [‐0.33, 0.11]
11 Mental state: 1. Change in PANSS by 12 weeks ‐ total (continuous, high score = poor)*	5	1815	Mean Difference (IV, Fixed, 95% CI)	‐1.52 [‐4.01, 0.97]
12 Mental state: 2. Change in PANSS by 12 weeks ‐ negative (continuous, high score = poor)*	4	1820	Mean Difference (IV, Fixed, 95% CI)	‐0.77 [‐1.62, 0.07]
13 Mental state: 3. Change in PANSS by 12 weeks ‐ positive (continuous, high score = poor)*	4	1820	Mean Difference (IV, Fixed, 95% CI)	‐0.24 [‐1.09, 0.60]
14 Mental state: 4. Change in BPRS by 12 weeks (continuous, high score = poor)*	4	1820	Mean Difference (IV, Fixed, 95% CI)	‐1.70 [‐3.22, ‐0.17]
15 Mental state: 5. PANSS endpoint score by 6 weeks (continuous, high score = poor)	1	20	Mean Difference (IV, Fixed, 95% CI)	‐2.75 [‐3.94, ‐1.56]
16 Mental state: 6. Anxiety/tension: short‐term (up to 12 weeks)	5	2087	Risk Ratio (M‐H, Fixed, 95% CI)	1.05 [0.79, 1.38]
17 Mental state: 7. Depression: short‐term (up to 12 weeks)	2	169	Risk Ratio (M‐H, Fixed, 95% CI)	0.72 [0.41, 1.25]
18 Behaviour: 1. Agitation: short‐term (up to 12 weeks)	4	724	Risk Ratio (M‐H, Fixed, 95% CI)	0.88 [0.64, 1.20]
19 Behaviour: 2. Use of medication for sedation: short‐term (up to 12 weeks)	3	198	Risk Ratio (M‐H, Fixed, 95% CI)	1.04 [0.79, 1.37]
20 Cognitive function: short‐term (up to 12 weeks)	4		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
20.1 concentration difficulties	4	1548	Risk Ratio (M‐H, Fixed, 95% CI)	0.90 [0.75, 1.07]
20.2 memory difficulties	2	1469	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.69, 1.03]
21 Acceptability of treatment: 1a. Leaving study early ‐ adverse effect	11		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
21.1 short‐term (up to 12 weeks)	11	2243	Risk Ratio (M‐H, Fixed, 95% CI)	0.82 [0.61, 1.09]
22 Acceptability of treatment: 1b. Leaving study early ‐ insufficient response	11	2498	Peto Odds Ratio (Peto, Fixed, 95% CI)	0.81 [0.60, 1.08]
22.1 short‐term (up to 12 weeks)	11	2498	Peto Odds Ratio (Peto, Fixed, 95% CI)	0.81 [0.60, 1.08]
23 Acceptability of treatment: 1c. Leaving the study early ‐ any reason	23	4364	Peto Odds Ratio (Peto, Fixed, 95% CI)	0.69 [0.59, 0.80]
23.1 short‐term (up to 12 weeks)	18	3066	Peto Odds Ratio (Peto, Fixed, 95% CI)	0.76 [0.63, 0.92]
23.2 medium term (12‐26 weeks)	1	28	Peto Odds Ratio (Peto, Fixed, 95% CI)	1.24 [0.17, 9.04]
23.3 long‐term (over 26 weeks)	4	1270	Peto Odds Ratio (Peto, Fixed, 95% CI)	0.55 [0.42, 0.73]
24 Acceptability of treatment: 2. Not acceptable ‐ as measured by direct questioning	1	60	Risk Ratio (M‐H, Fixed, 95% CI)	0.70 [0.40, 1.21]
24.1 short‐term (up to 12 weeks)	1	60	Risk Ratio (M‐H, Fixed, 95% CI)	0.70 [0.40, 1.21]
25 Adverse effects: 1. Experiencing at least one adverse effect	9	1276	Risk Ratio (M‐H, Fixed, 95% CI)	0.98 [0.93, 1.02]
26 Adverse effects: 2. Movement disorders ‐ general	14		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
26.1 general movement disorders (extrapyramidal side effects)	10	2702	Risk Ratio (M‐H, Fixed, 95% CI)	0.63 [0.56, 0.71]
26.2 use of medication for movement disorders (antiparkinsonian drugs)	11	2524	Risk Ratio (M‐H, Fixed, 95% CI)	0.66 [0.58, 0.74]
26.3 number of people whose need for antiparkinson medication ceased during trial	1	88	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.39, 2.92]
27 Adverse effects: 3. Movement disorders ‐ specific	7		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
27.1 abnormal involuntary movements (tardive dyskinesia)	1	62	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.07, 15.28]
27.2 distressing restlessness (akathesia)	4	731	Risk Ratio (M‐H, Fixed, 95% CI)	0.68 [0.52, 0.89]
27.3 postural disturbance (dystonia)	2	169	Risk Ratio (M‐H, Fixed, 95% CI)	0.72 [0.26, 1.99]
27.4 slow impovershed movement, stiffness (parkinsonism)	1	62	Risk Ratio (M‐H, Fixed, 95% CI)	0.89 [0.70, 1.12]
27.5 tremor	2	101	Risk Ratio (M‐H, Fixed, 95% CI)	0.97 [0.51, 1.83]
28 Adverse effects: 4. Movement disorders ‐ change in CGI (high score = poor)	4		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
28.1 severity of dyskinesia	3	1778	Mean Difference (IV, Fixed, 95% CI)	‐0.20 [‐0.34, ‐0.06]
28.2 severity of parkinsonism	3	468	Mean Difference (IV, Fixed, 95% CI)	‐0.78 [‐1.18, ‐0.39]
29 Adverse effects: 5. Movement disorders ‐ change in ESRS (high score = poor)	4		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
29.1 severity of parkinsonism	3	1507	Mean Difference (IV, Fixed, 95% CI)	‐2.07 [‐2.91, ‐1.23]
29.2 total	3	1708	Mean Difference (IV, Fixed, 95% CI)	‐0.68 [‐1.22, ‐0.15]
30 Adverse effects: 6. Movement disorders ‐ change in UKU (high score = poor)	1	1350	Mean Difference (IV, Fixed, 95% CI)	‐0.49 [‐0.51, ‐0.47]
31 Adverse effects: 7. SAS endpoint score by 6 weeks ( high score = poor)	1	20	Mean Difference (IV, Fixed, 95% CI)	‐0.35 [‐0.55, ‐0.15]
32 Adverse effects: 8. Anticholinergic effects (dry mouth, blurred vision, constipation, urinary difficulties)	9		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
32.1 dry mouth	5	1616	Risk Ratio (M‐H, Fixed, 95% CI)	0.80 [0.59, 1.09]
32.2 blurred vision	5	1635	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.62, 1.10]
32.3 constipation	7	2165	Risk Ratio (M‐H, Fixed, 95% CI)	1.04 [0.80, 1.37]
32.4 difficulties passing urine	3	210	Risk Ratio (M‐H, Fixed, 95% CI)	0.24 [0.03, 2.12]
33 Adverse effects: 9. Sleep problems	14		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
33.1 reduction ‐ insomnia	7	2699	Risk Ratio (M‐H, Fixed, 95% CI)	0.96 [0.82, 1.14]
33.2 reduction ‐ decreased duration or quality	3	1510	Risk Ratio (M‐H, Fixed, 95% CI)	0.89 [0.69, 1.14]
33.3 increase ‐ duration of sleep	2	1469	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.76, 1.18]
33.4 increase ‐ day time sleepiness (somnolence)	12	2711	Risk Ratio (M‐H, Fixed, 95% CI)	0.89 [0.79, 1.01]
34 Adverse effects: 10. Weight change	4		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
34.1 loss	2	1469	Risk Ratio (M‐H, Fixed, 95% CI)	1.23 [0.98, 1.56]
34.2 gain	4	1708	Risk Ratio (M‐H, Fixed, 95% CI)	1.55 [1.25, 1.93]
35 Adverse effects: 11. Gastrointestinal problems	3		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
35.1 dyspepsia	1	322	Risk Ratio (M‐H, Fixed, 95% CI)	1.55 [0.47, 5.09]
35.2 nausea	2	366	Risk Ratio (M‐H, Fixed, 95% CI)	1.18 [0.57, 2.44]
35.3 vomiting	2	689	Risk Ratio (M‐H, Fixed, 95% CI)	0.74 [0.43, 1.26]
36 Adverse effects: 12. Central nervous system	10		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
36.1 dizziness	7	2426	Risk Ratio (M‐H, Fixed, 95% CI)	1.15 [0.92, 1.43]
36.2 headache	10	2891	Risk Ratio (M‐H, Fixed, 95% CI)	1.06 [0.88, 1.27]
37 Adverse effects: 13. Cardiovascular	6		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
37.1 increased heart rate (tachycardia)	3	419	Risk Ratio (M‐H, Fixed, 95% CI)	0.85 [0.39, 1.82]
37.2 palpitations	2	85	Risk Ratio (M‐H, Fixed, 95% CI)	0.85 [0.32, 2.26]
37.3 low blood pressure (hypotension)	2	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.96 [0.38, 2.43]
37.4 high blood pressure (hypertension)	1	367	Risk Ratio (M‐H, Fixed, 95% CI)	0.67 [0.35, 1.27]
38 Adverse effects: 14. Sexual problems	3		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
38.1 erectile dysfunction	2	106	Risk Ratio (M‐H, Fixed, 95% CI)	1.55 [0.58, 4.20]
38.2 ejaculatory dysfunction	1	29	Risk Ratio (M‐H, Fixed, 95% CI)	4.12 [0.21, 78.89]
38.3 orgastic dysfunction	1	107	Risk Ratio (M‐H, Fixed, 95% CI)	1.89 [0.36, 9.89]
38.4 diminished sexual desire	2	1469	Risk Ratio (M‐H, Fixed, 95% CI)	0.96 [0.66, 1.41]
39 Adverse effects: 15. Menstrual problems	2		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
39.1 amenorrhea	2	45	Risk Ratio (M‐H, Fixed, 95% CI)	1.86 [0.42, 8.17]
39.2 menorrhagia	1	30	Risk Ratio (M‐H, Fixed, 95% CI)	3.0 [0.13, 68.26]
40 Adverse effects: 16. Other	8		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
40.1 nasal inflammation (rhinitis)	3	656	Risk Ratio (M‐H, Fixed, 95% CI)	1.99 [1.24, 3.19]
40.2 sweating	5	1606	Risk Ratio (M‐H, Fixed, 95% CI)	0.75 [0.55, 1.02]
40.3 too much saliva	1	183	Risk Ratio (M‐H, Fixed, 95% CI)	0.42 [0.08, 2.26]
40.4 psychosis	1	367	Risk Ratio (M‐H, Fixed, 95% CI)	0.70 [0.47, 1.04]
40.5 injury	1	367	Risk Ratio (M‐H, Fixed, 95% CI)	1.23 [0.68, 2.22]