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Tawny Bettinger and colleagues at the College of Pharmacy, University of Texas at Austin undertook a Multi-Attribute evaluation of six atypical anti-psychotics for schizophrenia (first line treatment). - Efficacy
Adverse Effects
Cost
Adherence
NMS (Neuroleptic Malignant Syndrome)
EPS (ExtraPyramidal Symptoms)
Prolactin
Weight gain
Glucose
Lipids
QTc interval prolongation
Sedation
Hypotension
Anticholinergic Risperidone
Olanzapine
Quetiapine
Ziprasidone
Aripiprazole
Risperdal Consta From consensus statements/guidelines or, if not these sufficient, peer-reviewed mansuscripts and package inserts. The overall Adverse Effects  Ratings were derived from a second level Multi-Attribute analysis, with 10 adverse effects rated and then equally weighted Subjectively assigned by authors at both levels Since Aripiprazole is outperformed only by Risperidone on Cost (marginally) and by Risperdal Consta on Adherence it would require 100% weight to be given to one of those attributes for it not to emerge as best overall. On the second level analysis for Adverse Effects Aripiprazole is outperformed only by Quetiapine on EPS and by Ziprasidone on Sedation so again it would require 100% weight to be given to one of those attributes for Aripiprazole not to emerge as best on Adverse Effects. Tawny L Bettinger, Garyn Shuler, Donnamaria R Jones and James P Wilson (2007) 'Schizophrenia: Multi-Attribute Utility theory approach to selection of atypical antipsychotics' Annals of Pharmacotherapy 41 (February) pp 201-207 Slide 1 reproduces the data and results in the paper. Slide 2 uses slightly different Adverse Effect ratings derived from our second level analysis of Adverse Effects. The latter is presented in slide 3. Aripiprazole is effectively dominant at both levels but it may be useful to have this adverse effect file available for when more or better data become available
download toplevel alt file here download adverse effects alt file here
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