Schizophrenia is a mental health problem that can be long term and can severely disable some of the people who have it, especially in terms of quality of life and inclusion into wider society. The main treatment is medication (antipsychotics) and while some people find a drug which decreases their symptoms and does not give them a lot of adverse effects, there are others who are ‘treatment resistant’ i.e. none of the medication available works for them. There are some antipsychotics, such as clozapine and sertindole that can have quite dangerous side-effects in some people. However, if they benefit people for whom nothing else works, the extra monitoring of these side-effects that is needed, can perhaps be justified.
This review aims to compare sertindole to the other newer second generation (atypical) antipsychotics in people who have schizophrenia. Two studies were identified which included 508 people. Both compared sertindole to risperidone, were short (12 weeks) and the participants were either at least moderately ill or treatment resistant. There was no overall significant difference between these two medications in terms of improvement in people’s general well-being or their mental state. Also while people on risperidone showed more movement side-effects, those on sertindole were more likely to put on weight, have changes in their heart rhythm and the men were more likely to suffer from sexual dysfunction.
The data from these trials are limited and a considerable number of the participants left the study early. In addition, sertindole has only been compared to one second generation antipsychotic and the trials are relatively short. A larger and longer trial comparing sertindole to other second generation antipsychotics, with the outcomes including mental state, general functioning, adverse effects and quality of life, would enhance our knowledge in this area considerably.
(Plain language summary prepared for this review by Janey Antoniou of RETHINK, UK www.rethink.org).