Evidence category

Antipsychotics.

First- and second-generation antipsychotics — efficacy, metabolic effects, and discontinuation.

1 review

Evidence ReviewAugust 2026

Antipsychotics and the Evidence

All antipsychotics beat placebo in acute trials (SMD 0.33–0.88), but 74% of CATIE participants discontinued within 18 months, dose reduction in first-episode patients doubled 7-year recovery rates versus maintenance treatment, and long-term observational data show better outcomes off medication—confounded by selection, but challenging the 'indefinite treatment for all' assumption.