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meta antipsychotic

Wei Zheng, Ying-Jun Zheng, Xian-Bin Li, Yi-Lang Tang, Chuan-Yue Wang, Ying-Qiang Xiang, Jose de Leon
This meta-analysis of randomized controlled trials (RCTs) evaluated the efficacy and safety of adding aripiprazole to other antipsychotics in schizophrenia. A systematic computer search identified 55 RCTs including 4457 patients who were randomized to aripiprazole (14.0 ± 7.0 mg/d) versus placebo (18 RCTs) or open antipsychotic treatment (37 RCTs). Aripiprazole significantly outperformed the comparison interventions based on psychiatric scales: (1) total score in 43 RCTs (N = 3351) with a standardized mean difference (SMD) of -0...
October 17, 2016: Journal of Clinical Psychopharmacology
Anne Marie Greenhalgh, Leticia Gonzalez-Blanco, Clemente Garcia-Rizo, Emilio Fernandez-Egea, Brian Miller, Miguel Bernardo Arroyo, Brian Kirkpatrick
BACKGROUND: Some studies have suggested that antipsychotic-naïve patients with nonaffective psychosis (NAP) have glucose intolerance. AIMS: To conduct a systematic review and meta-analysis of fasting glucose (FG), two hour values in the oral glucose tolerance test (2HG), fasting insulin concentration (INS), and insulin resistance (IR). METHOD: We identified possibly relevant studies, then selected studies, following usual guidelines, with two authors reviewing the manuscripts...
October 13, 2016: Schizophrenia Research
Benjamin Ian Perry, Gemma McIntosh, Scott Weich, Swaran Singh, Karen Rees
BACKGROUND: Schizophrenia might share intrinsic inflammatory disease pathways with type 2 diabetes. We aimed to assess whether first-episode psychosis, which could be described as developing schizophrenia, is associated with prediabetic markers, or developing diabetes, to determine whether intrinsic disease links could cause the disorders to develop in unison. We hypothesised that biochemical measures of prediabetic states would be more common in antipsychotic naive patients with first-episode psychosis than in healthy matched controls...
October 5, 2016: Lancet Psychiatry
Seo-Eun Cho, Kyoung-Sae Na, Seong-Jin Cho, Seung Gul Kang
An increasing amount of evidence indicates that d-serine, a potent and selective endogenous coagonist of the N-methyl-d-aspartate receptor (NMDAR), is efficacious in the treatment of schizophrenia. Although the therapeutic efficacy of d-serine supplementation is based on the d-serine deficit and NMDAR hypofunction hypothesis, it has not been confirmed whether d-serine levels are decreased in patients with schizophrenia compared to healthy controls. We searched the following electronic databases: Embase, Ovid Medline, and the Cochrane Library...
October 4, 2016: Neuroscience Letters
Varuni Asanka de Silva, Chathurie Suraweera, Suhashini S Ratnatunga, Madhubashinee Dayabandara, Nimali Wanniarachchi, Raveen Hanwella
BACKGROUND: Most antipsychotics are associated with weight gain and other metabolic complications. Several randomized trials have shown metformin to be effective, but this still hasn't been included in clinical guidelines on managing antipsychotic induced weight gain. METHODS: All double blind placebo controlled trials assessing the efficacy of metformin in the treatment of antipsychotic induced weight gain were included. Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE were searched for the period January 2000-December 2015...
October 3, 2016: BMC Psychiatry
Viola Korczak, Adrienne Kirby, Naren Gunja
OBJECTIVE: Chemical agents commonly used to sedate agitated patients in the emergency department include benzodiazepines, antipsychotics, or a combination of the 2 classes. Our objective was to determine if a class or combination therapy is (1) more effective, as measured by the proportion sedated at 15-20 minutes and the need for repeat sedation, and (2) safer, as measured by the proportion of reported adverse events. METHODS: Systematic literature review and meta-analysis of studies comparing 2 or more chemical agents for sedation of agitated patients in the emergency department were carried out in PubMed, PsycINFO, Embase, and the Cochrane database...
September 16, 2016: American Journal of Emergency Medicine
Ying Jiao Zhao, Liang Lin, Monica Teng, Ai Leng Khoo, Lay Beng Soh, Toshiaki A Furukawa, Ross J Baldessarini, Boon Peng Lim, Kang Sim
BACKGROUND: For treatment of patients diagnosed with schizophrenia, comparative long-term effectiveness of antipsychotic drugs to reduce relapses when minimising adverse effects is of clinical interest, hence prompting this review. AIMS: To evaluate the comparative long-term effectiveness of antipsychotic drugs. METHOD: We systematically searched electronic databases for reports of randomised controlled trials (RCTs) of antipsychotic monotherapy aimed at reducing relapse risks in schizophrenia...
January 2016: BJPsych Open
Gavin Deas, Christopher Kelly, Andreas V Hadjinicolaou, Clare Holt, Mark Agius, Rashid Zaman
INTRODUCTION: There are now many existing studies which assess the treatments available for 'at risk mental states', as patients who are believed to be in the prodromal phase of psychotic illness are referred to. However, concerns regarding side effects of possible treatments remain. We here conduct a meta-analysis of the studies available up to July 2016. The aim of this study is to decide what would be the best treatment for 'at high risk patients'. RESULTS: 18 studies were selected for inclusion; 12 showed significance, 5 did not and one tended towards significance...
September 2016: Psychiatria Danubina
Monika Edlinger, Maria A Rettenbacher, Georg Kemmler, Falko Biedermann, Christian G Widschwendter, W Wolfgang Fleischhacker, Alex Hofer
OBJECTIVE: The primary objective of this study was to investigate whether the choice and dosage of antipsychotic medication differ between patients with schizophrenia starting treatment in an inpatient or outpatient unit. In addition, we investigated whether the reason for the introduction of new antipsychotic medication had an impact on the treatment setting and whether the use of benzodiazepines differed between inpatients and outpatients. METHOD: From October 1997 to September 2010, patients with a schizophrenia spectrum disorder according to the International Classification of Diseases, Tenth Revision aged between 18 and 65 years were allocated to a naturalistic drug-monitoring program when starting treatment with a second-generation antipsychotic drug...
September 21, 2016: Journal of Clinical Psychopharmacology
Virginio Salvi, Claudio Mencacci, Francesco Barone-Adesi
Weight gain and metabolic abnormalities are extensively found in patients taking psychotropic medications. Although mainly antipsychotics have been implicated, also antidepressants carry the potential to induce weight gain, with tricyclics and mirtazapine being associated with the greatest weight gain. It has been suggested that this could be due to the different ability of antidepressants to block adrenergic, cholinergic, and histaminergic postsynaptic receptors. To date, however, the link between antidepressant-induced weight gain and their receptor affinity profile has not been established...
October 2016: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
W Zheng, Y-T Xiang, Y-Q Xiang, X-B Li, G S Ungvari, H F K Chiu, C U Correll
OBJECTIVE: To systematically examine the randomized controlled trial (RCT) evidence regarding efficacy and tolerability of topiramate cotreatment with antipsychotics in schizophrenia-spectrum disorders. METHODS: Random-effects meta-analysis of RCTs of topiramate cotreatment with antipsychotics vs. placebo/ongoing antipsychotic treatment in schizophrenia-spectrum disorders. Standardized or weighted mean difference (SMD/WMD), risk ratio (RR) ±95% confidence intervals (CIs), and number needed to harm (NNH) were calculated...
November 2016: Acta Psychiatrica Scandinavica
Rajesh R Tampi, Deena J Tampi, Silpa Balachandran, Shilpa Srinivasan
BACKGROUND: The purpose of this review is to evaluate the data on the use of antipsychotics in individuals with dementia from meta-analyses. METHODS: We performed a literature search of PubMed, MEDLINE, EMBASE, PsycINFO and Cochrane collaboration databases through 30 November, 2015 using the following keywords: 'antipsychotics', 'dementia' and 'meta-analysis'. The search was not restricted by the age of the patients or the language of the study. However, in the final analysis we only included studies involving patients that were published in English language journals or had official English translations...
September 2016: Therapeutic Advances in Chronic Disease
Isabella Pacchiarotti, Jordi León-Caballero, Andrea Murru, Norma Verdolini, Maria Antonietta Furio, Corinna Pancheri, Marc Valentí, Ludovic Samalin, Eva Solé Roigé, Ana González-Pinto, Jose Manuel Montes, Antonio Benabarre, Jose Manuel Crespo, Consuelo de Dios Perrino, Jose Manuel Goikolea, Luis Gutiérrez-Rojas, André F Carvalho, Eduard Vieta
Breast milk is considered the best source of nutrients and provides much better protection than immune modified milk. However, the postpartum period is a phase of increased risk for all women to experience psychiatric symptoms and recurrences or new episodes of bipolar disorder (BD), especially in those who have discontinued treatment. This is a systematic review of the risks and benefits of mood stabilizers and antipsychotics during breastfeeding as they relate to the health and well-being of mothers and their infants...
October 2016: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
Kim S J Lao, Ying He, Ian C K Wong, Frank M C Besag, Esther W Chan
BACKGROUND: Cariprazine is a novel antipsychotic agent recently approved for treating schizophrenia and bipolar mania in the USA. The sample sizes of published randomized controlled trials (RCTs) of the drug are small; previous meta-analyses included few RCTs and did not specifically investigate the tolerability/safety profile of cariprazine. OBJECTIVE: Our objective was to conduct a meta-analysis of published RCTs to systematically review the tolerability and safety of cariprazine versus placebo...
August 22, 2016: CNS Drugs
Michael H Bloch
In this issue, Whittington et al. (2016) present a systematic review that reports the efficacy of three primary treatments for children with Tourette syndrome (TS) - (a) α2-adrenergic receptor agonists; (b) antipsychotic medications; and (c) habit reversal training/comprehensive behavioral intervention. In this commentary, we highlight the large degree of heterogeneity observed in the meta-analysis of trials involving alpha-2 agonist medications and present possible explanations for the observed heterogeneity...
September 2016: Journal of Child Psychology and Psychiatry, and Allied Disciplines
Alexander Wolf, Stefan Leucht, Frank-Gerald Pajonk
Behavioural and psychological symptoms in dementia (BPSD) are common and often treated with antipsychotics, which are known to have small efficacy and to cause many side effects. One potential side effect might be cognitive decline. We searched MEDLINE, Scopus, CENTRAL and for randomized, double-blind, placebo-controlled trials using antipsychotics for treating BPSD and evaluated cognitive functioning. The studies identified were summarized in a meta-analysis with the standardized mean difference (SMD, Hedges's g) as the effect size...
August 16, 2016: European Archives of Psychiatry and Clinical Neuroscience
Fuminari Misawa, Taishiro Kishimoto, Katsuhiko Hagi, John M Kane, Christoph U Correll
OBJECTIVE: We aimed to assess whether long-acting injectable antipsychotics (LAIs), which are initiated in a loading strategy or overlapping with oral antipsychotics (OAPs) and which cannot be stopped immediately, are associated with greater safety/tolerability issues than OAPs. METHOD: Systematic review and meta-analysis of randomized controlled trials (RCTs) comparing LAIs and OAPs, including only LAI-OAP pairs of the same OAP (allowing oral risperidone and paliperidone as comparators for either risperidone or paliperidone LAI)...
October 2016: Schizophrenia Research
Jorge Zimbron, Golam M Khandaker, Chiara Toschi, Peter B Jones, Emilio Fernandez-Egea
Metabolic complications are commonly found in people treated with clozapine. Reviews on the management of this problem have generally drawn conclusions by grouping different types of studies involving patients treated with various different antipsychotics. We carried out a systematic review and meta-analysis of pharmacological and non-pharmacological treatments for clozapine-induced obesity or metabolic syndrome. Two researchers independently searched PubMed and Embase for randomised controlled trials (RCTs) of treatments for clozapine-induced obesity or metabolic syndrome...
September 2016: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
Melissa Pyle, John Norrie, Matthias Schwannauer, David Kingdon, Andrew Gumley, Douglas Turkington, Rory Byrne, Suzy Syrett, Graeme MacLennan, Robert Dudley, Hamish J McLeod, Helen Griffiths, Samantha Bowe, Thomas R E Barnes, Paul French, Paul Hutton, Linda Davies, Anthony P Morrison
BACKGROUND: For around a third of people with a diagnosis of schizophrenia, the condition proves to respond poorly to treatment with many typical and atypical antipsychotics. This is commonly referred to as treatment-resistant schizophrenia. Clozapine is the only antipsychotic with convincing efficacy for people whose symptoms are considered treatment-resistant to antipsychotic medication. However, 30-40 % of such conditions will have an insufficient response to the drug. Cognitive behavioural therapy has been shown to be an effective treatment for schizophrenia when delivered in combination with antipsychotic medication, with several meta-analyses showing robust support for this approach...
2016: BMC Psychiatry
Alessio Crippa, Nicola Orsini
BACKGROUND: Meta-analytical methods are frequently used to combine dose-response findings expressed in terms of relative risks. However, no methodology has been established when results are summarized in terms of differences in means of quantitative outcomes. METHODS: We proposed a two-stage approach. A flexible dose-response model is estimated within each study (first stage) taking into account the covariance of the data points (mean differences, standardized mean differences)...
2016: BMC Medical Research Methodology
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