UM  > 健康科學學院
Safety and tolerability of antipsychotic co-treatment in patients with schizophrenia: results from a systematic review and meta-analysis of randomized controlled trials
Galling, B1; Roldan, A2; Rietschel, L3; Hagi, K1,4; Walyzada, F1; Zheng, W5; Cao, XL6; Xiang, YT7; Kane, JM1,8,9,10; Correll, CU1,8,9,10
2016
Source PublicationEXPERT OPINION ON DRUG SAFETY
ISSN1474-0338
Volume15Issue:5Pages:591-612
Abstract

Introduction: Antipsychotic co-treatment is common in schizophrenia, despite lacking evidence for its efficacy and safety. 

Areas: We conducted a systematic search of PubMed/PsycInfo/CJN/WangFan/CBM without language restrictions from database inception until 05/25/2015 for randomized trials comparing antipsychoticmonotherapy with antipsychotic co-treatment in >= 20 adults with schizophrenia reporting meta-analyzable adverse events (AEs) data. Meta-analyzing 67 studies (n=4,861, duration=10.3 +/- 5.2 weeks), antipsychotic co-treatment was similar to monotherapy regarding intolerability-related discontinuation (risk ratio (RR)=0.84, 95% confidence interval (CI)=0.53-1.33, p=0.455). While incidence of >= 1 AE was lower with antipsychotic co-treatment (RR=0.77, 95%CI=0.66-0.90, p=0.001), these results were solely driven by open-label and efficacy-focused studies. Adjunctive D2-antagonists lead to less nausea (RR=0.220, 95%CI=0.06-0.87, p=0.030) and insomnia (RR=0.26, 95%CI=0.08-0.86, p=0.028), but higher prolactin (SMD=2.20, 95%CI=0.43-3.96, p=0.015). Conversely, adjunctive partial D2-agonists (aripiprazole=100%) resulted in lower electrocardiogram abnormalities (RR=0.43, 95%CI=0.25-0.73, p=0.002), constipation (RR=0.45, 95%CI=0.25-0.79, p=0.006), drooling/hypersalivation (RR=0.14, 95%CI=0.07-0.29, p<0.001), prolactin (SMD=-1.77, 95%CI=-2.38, -1.15, p<0.001), total and LDL-cholesterol (SMD=-0.33, 95%CI=-0.55, -0.11, p=0.003; SMD=-0.33, 95%CI=-0.54, -0.10, p=0.004). 

Expert opinion: No double-blind evidence for altered AE burden associated with antipsychotic co-treatment was found. However, AEs were insufficiently and incompletely reported and follow-up duration was modest. Adjunctive partial D2-agonists might be beneficial for counteracting several AEs. High-quality, long-term studies that comprehensively assess AEs are needed.

KeywordMonotherapy Metaanalysis Antipsychotics Augmentation Combination Polypharmacy Cotreatment Adverse Effects Tolerability Safety Schizophrenia
DOIhttp://doi.org/10.1517/14740338.2016.1165668
Indexed BySCI
Language英语
WOS Research AreaPharmacology & Pharmacy
WOS SubjectPharmacology & Pharmacy
WOS IDWOS:000374954800003
Fulltext Access
Citation statistics
Cited Times [WOS]:16   [WOS Record]     [Related Records in WOS]
Document TypeJournal article
CollectionFaculty of Health Sciences
Affiliation1.Northwell Hlth, Zucker Hillside Hosp, Psychiat Res, Glen Oaks, NY USA
2.Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Psychiat, Inst Invest Biomed St Pau, E-08193 Barcelona, Spain
3.Univ Bern, Univ Hosp Child & Adolescent Psychiat & Psychothe, Bern, Switzerland
4.Sumitomo Dainippon Pharma Co Ltd, Med Affairs, Tokyo, Japan
5.Guangzhou Med Univ, Affilated Hosp, Guangzhou Huiai Hosp, Dept Psychiat,Guangzhou Brain Hosp, Guangzhou, Guangdong, Peoples R China
6.Chinese Univ Hong Kong, Dept Psychiat, Hong Kong, Hong Kong, Peoples R China
7.Univ Macau, Unit Psychiat, Fac Hlth Sci, Macau, Peoples R China
8.Hofstra North Shore LIJ Sch Med, Hempstead, NY USA
9.Feinstein Inst Med Res, Manhasset, NY USA
10.Albert Einstein Coll Med, Bronx, NY 10467 USA
Recommended Citation
GB/T 7714
Galling, B,Roldan, A,Rietschel, L,et al. Safety and tolerability of antipsychotic co-treatment in patients with schizophrenia: results from a systematic review and meta-analysis of randomized controlled trials[J]. EXPERT OPINION ON DRUG SAFETY,2016,15(5):591-612.
APA Galling, B.,Roldan, A.,Rietschel, L.,Hagi, K.,Walyzada, F.,...&Correll, CU.(2016).Safety and tolerability of antipsychotic co-treatment in patients with schizophrenia: results from a systematic review and meta-analysis of randomized controlled trials.EXPERT OPINION ON DRUG SAFETY,15(5),591-612.
MLA Galling, B,et al."Safety and tolerability of antipsychotic co-treatment in patients with schizophrenia: results from a systematic review and meta-analysis of randomized controlled trials".EXPERT OPINION ON DRUG SAFETY 15.5(2016):591-612.
Related Services
Recommend this item
Bookmark
Usage statistics
Export to Endnote
Google Scholar
Similar articles in Google Scholar
[Galling, B]'s Articles
[Roldan, A]'s Articles
[Rietschel, L]'s Articles
Baidu academic
Similar articles in Baidu academic
[Galling, B]'s Articles
[Roldan, A]'s Articles
[Rietschel, L]'s Articles
Bing Scholar
Similar articles in Bing Scholar
[Galling, B]'s Articles
[Roldan, A]'s Articles
[Rietschel, L]'s Articles
Terms of Use
No data!
Social Bookmark/Share
All comments (0)
No comment.
 

Items in the repository are protected by copyright, with all rights reserved, unless otherwise indicated.