Review ArticlesA systematic review of studies with clinician-rated scales on the pharmacological treatment of delusional disorderMuñoz-Negro, José Eduardoa,,b,,c; Gómez-Sierra, Francisco Joséa,,b; Peralta, Victord,,e; González-Rodríguez, Alexandref; Cervilla, Jorge A.a,,b,,cAuthor Information aHospital Universitario Clínico San Cecilio, Servicio Andaluz de Salud bDepartament of Psychiatry. University of Granada cInstituto de Investigación Biosanitaria, Ibs Granada, Granada, Spain dMental Health Department, Servicio Navarro de Salud-Osasunbidea eInstituto de Investigación Sanitaria de Navarra (IdISNa), Navarra fDepartment of Mental Health, Parc Tauli University Hospital, Barcelona, Spain Received 22 October 2019 Accepted 16 January 2020 Correspondence to José Eduardo Muñoz-Negro, Department of Psychiatry, Faculty of Medicine, University of Granada, Avenida de la Investigación No 11, 18016 Granada, Spain, Tel: +34 958 24 15 04; fax: +34 958 24 07 30; e-mail: firstname.lastname@example.org International Clinical Psychopharmacology: May 2020 - Volume 35 - Issue 3 - p 129-136 doi: 10.1097/YIC.0000000000000306 Buy Metrics Abstract To collect the best available evidence and to compare the first-generation antipsychotics (FGAs) vs. the second-generation antipsychotics (SGAs) in the treatment of delusional disorder (DD). Systematic review including studies evaluating treatment response in DD using clinician-rated scales appearing in PubMed and Web of Science databases from inception till September 2019. Those studies meeting inclusion criteria were selected. Outcomes were summarized into two response categories: (1) response to treatment equal to or greater than 50% and (2) response less than 50%. Biases and quality of the studies were evaluated, and relevant data were extracted. Finally, both narrative review and quantitative synthesis were performed. The final sample included six studies (437 patients, 318 on treatment with SGAs). Antipsychotics achieved a good response in 32.3% of patients. Effectiveness differences between FGA and SGA were only marginal favouring the former. Among the most used antipsychotics, risperidone and olanzapine showed, respectively, 34.3 and 33.7% good response. Pimozide (n = 35) demonstrated a higher response rates compared with other antipsychotics. Inpatients showed the best treatment outcomes. Antipsychotics appeared to be an effective treatment in patients with DD. FGA were slightly superior to SGA. Pimozide does not seem to provide any advantage in most DD subtypes. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.