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Adjunctive azapirone for schizophrenia: A meta-analysis of randomized, double-blind, placebo-controlled trials
Zheng, Wei1; Li, Xiao-Hong2; Cai, Dong-Bin3; Yang, Xin-Hu1; Ungvari, Gabor S.4; Ng, Chee H.5; Ning, Yu-Ping6; Xiang, Yu-Tao7
2018-01
Source PublicationEUROPEAN NEUROPSYCHOPHARMACOLOGY
ISSN0924-977X
Volume28Issue:1Pages:149-158
Abstract

Azapirones, which are serotonin(1A) (5-HT1A) receptor partial agonists, have been used as an adjunctive treatment for schizophrenia with mixed results. This is a meta-analysis of the efficacy and tolerability of azapirones for schizophrenia based on randomized, double-blind, placebo-controlled trials (RCTs). English and Chinese databases were systematically and independently searched by two investigators. Data were extracted and analyzed using the RevMan software (version 5.3). Seven RCTs (n = 368) of azapirones (buspirone in 6 RCTs and tandospirone in 1 RCT) were identified and analyzed. Only adjunctive buspirone outperformed placebo regarding total psychopathology [standardized mean difference: -1.03 (95% confidence interval (CI): -1.91, -0.15), P = 0.02; I-2 = 92%], but the significance disappeared in sensitivity analysis after removing two outlying studies, and in 10 of the 12 subgroup analyses. In 5 RCTs examining neurocognitive function of azapirones, only 2 RCTs found the superiority of buspirone in improving attention/speeded motor performance, verbal and performance intelligence. Adjunctive buspirone outperformed placebo regarding extrapyramidal symptoms [SMD:-0.51, (95%CI: -0.99, -0.02), P = 0.04; I-2 = 0%]. Similar rates of discontinuation [risk ratio:1.06 (95%CI:0.54, 2.07), P = 0.86, I-2 = 0%] and adverse drug reactions were found between both groups. Adjunctive buspirone and tandospirone failed to show efficacy for psychotic symptoms, but adjunctive buspirone may be associated with improvement in extrapyramidal symptoms and cognitive deficits in schizophrenia. Due to the preliminary nature of this meta -analysis, larger sample size and higher quality RCTs are needed to confirm these finding. (C) 2017 Elsevier B.V. and ECNP. All rights reserved.

KeywordAzapirone Buspirone Tandospirone Schizophrenia Meta-analysis
DOIhttp://doi.org/10.1016/j.euroneuro.2017.11.007
URLView the original
Indexed BySCI ; SSCI ; SSCI
Language英语
WOS Research AreaNeurosciences & Neurology ; Pharmacology & Pharmacy ; Psychiatry
WOS SubjectClinical Neurology ; Neurosciences ; Pharmacology & Pharmacy ; Psychiatry
WOS IDWOS:000419141900014
PublisherELSEVIER SCIENCE BV
The Source to ArticleWOS
Fulltext Access
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Document TypeJournal article
CollectionFaculty of Health Sciences
Corresponding AuthorNing, Yu-Ping; Xiang, Yu-Tao
Affiliation1.The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
2.The National Clinical Research Center for Mental Disorders, China &Center of Depression, Beijing Institute for Brain Disorders & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China.
3.Clinics of Chinese Medicine, the First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China.
4.The University of Notre Dame Australia / Graylands Hospital, Perth, Australia.
5.Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.
6.The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
7.Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
Corresponding Author AffilicationFaculty of Health Sciences
Recommended Citation
GB/T 7714
Zheng, Wei,Li, Xiao-Hong,Cai, Dong-Bin,et al. Adjunctive azapirone for schizophrenia: A meta-analysis of randomized, double-blind, placebo-controlled trials[J]. EUROPEAN NEUROPSYCHOPHARMACOLOGY,2018,28(1):149-158.
APA Zheng, Wei.,Li, Xiao-Hong.,Cai, Dong-Bin.,Yang, Xin-Hu.,Ungvari, Gabor S..,...&Xiang, Yu-Tao.(2018).Adjunctive azapirone for schizophrenia: A meta-analysis of randomized, double-blind, placebo-controlled trials.EUROPEAN NEUROPSYCHOPHARMACOLOGY,28(1),149-158.
MLA Zheng, Wei,et al."Adjunctive azapirone for schizophrenia: A meta-analysis of randomized, double-blind, placebo-controlled trials".EUROPEAN NEUROPSYCHOPHARMACOLOGY 28.1(2018):149-158.
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